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PEDIATRIC ASSOCIATES OF NE FLORIDA LLC NPI 1316367667


NPI Information

NPI: 1316367667
Provider Name: PEDIATRIC ASSOCIATES OF NE FLORIDA, LLC

Doing Business As: JACKSONVILLE PEDIATRIC ASSOCIATES

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D2164250

Address:
1951 BOULEVARD
JACKSONVILLE, FL
ZIP 32206
Phone: (904) 354-6868
Get Directions

PEDIATRIC ASSOCIATES OF NE FLORIDA, LLC 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. PEDIATRIC ASSOCIATES OF NE FLORIDA, LLC NPI is 1316367667. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Jacksonville Pediatric Associates.

The provider's business location address is:

1951 BOULEVARD
JACKSONVILLE, FL
ZIP 32206-527
Phone: (904) 354-6868
Fax: (904) 358-3067

The provider's authorized official is Patricia Corsiatto .
The authorized official title is Director and has the following contact phone number (954) 967-6400.

The CLIA number assigned to this NPI record is 10D2164250 - other - occupational med clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/24/2014 and was last updated on 8/25/2020.


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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1011962601MEDICAIDFLORIDA

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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