Organization
KIDS AND FAMILIES MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIA MITCHELL MD (AUTHORIZED OFFICIAL)
(904) 300-6248
Entity
Organization
Contact information
Practice address
12086 FORT CAROLINE RD STE 404, JACKSONVILLE, FL 32225-7640
(904) 300-6248
Mailing address
12086 FORT CAROLINE RD STE 404, JACKSONVILLE, FL 32225-7640
(904) 747-3800
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
Other
Enumeration date
04/24/2019
Last updated
06/09/2020
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