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PEDIATRIC INNOVATION CENTER LLC NPI 1457805756


NPI Information

NPI: 1457805756
Provider Name: PEDIATRIC INNOVATION CENTER, LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
13241 BARTRAM PARK BLVD
SUITE 209
JACKSONVILLE, FL
ZIP 32258
Phone: (904) 616-2772
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PEDIATRIC INNOVATION CENTER, 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 INNOVATION CENTER, LLC NPI is 1457805756. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13241 BARTRAM PARK BLVD
SUITE 209
JACKSONVILLE, FL
ZIP 32258-212
Phone: (904) 616-2772
Fax: (904) 674-2313

The provider's authorized official is Ashraf Affan .
The authorized official title is President and has the following contact phone number (904) 616-2772.

The enumeration date for this NPI number is 8/4/2016 and was last updated on 8/4/2016.


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
1208000000XPediatricsME86016FLORIDAYes

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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