LITTLE PINE PEDIATRICS PLLC NPI 1043761539

NPI Information

NPI: 1043761539
Provider Name: LITTLE PINE PEDIATRICS, PLLC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
CLIA Number: 10D2043308
Address: 194 NE HANCOCK AVE
MADISON, FL
ZIP 32340
Phone: (850) 253-2275

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NPI Details

LITTLE PINE PEDIATRICS, PLLC is a primary care clinic center in Madison, FL. LITTLE PINE PEDIATRICS, PLLC NPI is 1043761539. The provider is registered as an organization entity type.

The provider's business location address is:

194 NE HANCOCK AVE
MADISON, FL
ZIP 32340-546
Phone: (850) 253-2275
Fax: (850) 253-2280

The provider's authorized official is Ronald Emerick .
The authorized official title is Owner/medical Director and has the following contact phone number (850) 253-2275.

The CLIA number assigned to this NPI record is 10D2043308 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2016 and was last updated on 1/13/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001165802	MEDICAID	FLORIDA

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: 3/30/2025

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