Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Adolescent Medicine |
2080A0000X | 37 | Physician/Pediatric Medicine | |
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine |
| NPI Number | 1376548602 |
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| LBN Legal business name | NORTH FLORIDA PEDIATRICS, PA. | ||||||||
| Authorized official | SAMUEL SANTELICES - (PRESIDENT/ CEO) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | Yes | ||||||||
| Enumeration date | 06/14/2005 | ||||||||
| Last updated | 09/08/2021 - About 5 years ago | ||||||||
| Identifiers |
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