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Contact Information

NORTH FLORIDA PEDIATRICS, PA
NORTH FLORIDA PEDIATRICS, PA
1117 NW HWY 41 STE B
JASPER, FL32052
 Phone: 386-792-3864
 Fax: 386-792-1530
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rural Health

261QR1300X B4[14] Rural Health Clinic
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for NORTH FLORIDA PEDIATRICS, PA

NPI # 1033114285
LBN Legal business name NORTH FLORIDA PEDIATRICS, PA
Authorized official SAMUEL SANTELICES - (PRESIDENT/CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/15/2005
Last updated 09/08/2021 - About 5 years ago
Identifiers
FL License # ME87551
FL Medicaid 001534800
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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