National Provider Identifier Database

WB STEWART TIGERS ATHLETICS BOOSTERS
Adolescent Medicine

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.


Contact Information

W.B. STEWART TIGERS ATHLETICS BOOSTERS
1658 KINGS RD
JACKSONVILLE, FL32209-6167
Phone: 972-367-4845
Fax:
Website:
Specialty Taxonomy Code
* Adolescent Medicine 2080A0000X

* Indicates primary specialty

NPI Profile & details for W.B. STEWART TIGERS ATHLETICS BOOSTERS

NPI Number 1841794682
Legal business name
LBN
W.B. STEWART TIGERS ATHLETICS BOOSTERS
Authorized official MOUZON BASS - (AGENT)
Entity Organization
Organization subpart No
Enumeration date 03/19/2018
Last updated 03/19/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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