Abc Pediatrics

Organization Active NPI Pediatrics Physician · Niceville, FL

NPI 1548286552 · NPPES record last updated Oct 11, 2007

Key facts

NPI
1548286552
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
License
ME56157 (FL)
Legal business name
ABC PEDIATRICS
Practice address
1005 College Blvd W
Suite B
Niceville, FL 32578-1053
Phone
(850) 689-0900
NPI assigned
Jul 14, 2006
Organization subpart
No

Authorized official

Name
Lela Johnson
Title
Office Manager
Phone
(850) 689-0900

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Abc Pediatrics (3 organizations share this tax ID)

Locations

182 E Redstone Ave
Ste B
Crestview, FL 32539
Phone (850) 359-2644

600 Hospital Dr
Crestview, FL 32539
Phone (850) 279-4600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208000000X ME56157 FL Yes

Addresses

Primary practice location

1005 College Blvd W
Suite B
Niceville, FL 32578-1053

Mailing address

1005 College Blvd W
Suite B
Niceville, FL 32578-1053
Phone (850) 689-0900

Other providers in Niceville, FL

All providers in Niceville, FL · Pediatrics Physician in Florida

Sources for this page

Verify at the official NPI Registry.