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ANGEL KIDS PA NPI 1033785001


NPI Information

NPI: 1033785001
Provider Name: ANGEL KIDS PA
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D2157290

Address:
6801 BEACH BLVD
JACKSONVILLE, FL
ZIP 32216
Phone: (904) 242-4220
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ANGEL KIDS PA is a pediatrics in Jacksonville, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. ANGEL KIDS PA NPI is 1033785001. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6801 BEACH BLVD
JACKSONVILLE, FL
ZIP 32216-820
Phone: (904) 242-4220

The provider's authorized official is Azza Ghandour .
The authorized official title is Billing/credentialing Mananger and has the following contact phone number (904) 242-4220.

The CLIA number assigned to this NPI record is 10D2157290 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2021 and was last updated on 6/1/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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