Little Pine Pediatrics PLLC
Clinic/Center, Rural Health in Alachua, FL. Organization (NPI-2).
NPI number1043661994
StatusActive
Last updated in NPPESMar 3, 2021
Details
- NPI
- 1043661994
- Entity type
- Organization (NPI-2)
- Legal business name
- Little Pine Pediatrics PLLC
- Organization subpart
- No
- Enumeration date
- Jun 22, 2016
- Certification date
- Mar 3, 2021
- Last updated
- Mar 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
| 208000000X | Pediatrics | OS9746 | FL |
Practice location
15551 Nw Us Highway 441 Unit 40Alachua, FL 32615-9330
Phone 386-518-0102 · Fax 386-518-0116
Mailing address
1702 S Jefferson StPerry, FL 32348-5611
Authorized official
Ronald Emerick
Owner
8555775437
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