Organization
CHILDRENS CRITICAL CARE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY STEWART (CREDENTIALING COORDINATOR)
(727) 456-4250
Entity
Organization
Contact information
Practice address
1814 LUCERNE TER, SUITE C, ORLANDO, FL 32806-2949
(727) 767-4755
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-3288
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Enumeration date
08/25/2006
Last updated
08/22/2020
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