Organization
AG PEDIATRICS, LLC
Active
Other names
ST. THOMAS PEDIATRIC ASSOCIATE
Organization subpart
No
Provider details
NPI number
Authorized official
REDA AWAD MD (OWNER)
(727) 261-6464
Entity
Organization
Contact information
Practice address
7645 CITA LN UNIT 102, NEW PORT RICHEY, FL 34653-6220
(727) 261-6464
(727) 261-6458
Mailing address
7645 CITA LN UNIT 102, NEW PORT RICHEY, FL 34653-6220
(727) 261-6464
(727) 261-6458
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME110635
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010501900
—
FL
Enumeration date
12/27/2017
Last updated
12/27/2017
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