Organization
BAPTIST PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL MALLY (SR. VICE PRESIDENT)
(904) 376-4275
Entity
Organization
Contact information
Practice address
520 A1A N, SUITE 102, PONTE VEDRA BEACH, FL 32082-5212
(904) 280-1225
(904) 285-4522
Mailing address
520 A1A N, SUITE 102, PONTE VEDRA BEACH, FL 32082-5212
(904) 280-1225
(904) 285-4522
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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