Organization
FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Active
Other names
Pediatric Neonatology Group
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY SIBISKI (EXECUTIVE VICE PRESIDENT)
(352) 265-8017
Entity
Organization
Contact information
Practice address
1600 SW ARCHER RD, # 100296, GAINESVILLE, FL 32610-0296
(352) 273-8985
(352) 392-4533
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833
(352) 392-4195
(352) 392-4533
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
053386601
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053386601
—
FL
Enumeration date
06/05/2007
Last updated
07/19/2016
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