Nemours Children'S Health, Maitland, Primary Care
Pediatrics in Maitland, FL. Organization (NPI-2).
NPI number1639748809
StatusActive
Last updated in NPPESJun 22, 2021
Details
- NPI
- 1639748809
- Entity type
- Organization (NPI-2)
- Legal business name
- Nemours Children'S Health, Maitland, Primary Care
- Organization subpart
- Yes
- Enumeration date
- Jun 22, 2021
- Certification date
- Jun 22, 2021
- Last updated
- Jun 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
Practice location
100 E Sybelia Ave Ste 100Maitland, FL 32751-4748
Phone 407-127-9700
Mailing address
10140 Centurion Pkwy NJacksonville, FL 32256-0532
Authorized official
Robert Bridges
Evp, Operations
9046974000
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