NORTH FLORIDA PEDIATRICS PA NPI 1558602482

NPI Information

NPI: 1558602482
Provider Name: NORTH FLORIDA PEDIATRICS, PA
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
NORTH FLORIDA PEDIATRICS, PA
1101 OHIO AVENUE SOUTH
LIVE OAK, FL
ZIP 32064
Phone: (386) 339-1060
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NORTH FLORIDA PEDIATRICS, PA is a rural health clinic center in Live Oak, FL. NORTH FLORIDA PEDIATRICS, PA NPI is 1558602482. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

NORTH FLORIDA PEDIATRICS, PA
1101 OHIO AVENUE SOUTH
LIVE OAK, FL
ZIP 32064
Phone: (386) 339-1060
Fax: (386) 339-1067

The provider's authorized official is Samuel Santelices .
The authorized official title is President/ Ceo and has the following contact phone number (386) 758-0003.

The enumeration date for this NPI number is 3/1/2013 and was last updated on 9/8/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	208000000X	Pediatrics		NEW YORK	No
2	2080A0000X	Pediatrics	Adolescent Medicine		No
3	261QR1300X	Clinic/Center	Rural Health		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	015048100	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: 5/5/2024

NPI Synchronization or Removal

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