North Florida Pediatrics, PA
Organization Active NPI Pediatric Adolescent Medicine Physician · Ponte Vedra, FL
NPI 1609424217 · NPPES record last updated Sep 3, 2019
Key facts
- NPI
- 1609424217
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- Legal business name
- NORTH FLORIDA PEDIATRICS, PA
- Practice address
- 145 Hilden Road Suite 101
Ponte Vedra, FL 32081 - Phone
- (904) 393-4700
- Fax
- (904) 493-9700
- NPI assigned
- Aug 27, 2019
- Organization subpart
- No
Authorized official
- Name
- Mr. Samuel Santelices, M.D.
- Title
- President/Ceo
- Phone
- (386) 758-0003
Corporate family (same tax ID) 16
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1088347 | North Florida Pediatrics PA | Certificate of waiver | Oct 7, 2027 |
National Provider Directory
- Tax ID family
- North Florida Pediatrics PA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician |
2080A0000X | Yes |
Addresses
Primary practice location
145 Hilden Road Suite 101
Ponte Vedra, FL 32081
Mailing address
1859 SW Newland Way
Lake City, FL 32025
Phone (386) 758-0003
Other providers in Ponte Vedra, FL
- Edward Nicholson
- Aurelian Nicolaescu
- Nocal Behavioral Services LLC
- Laura Phelps Nord
- North Florida Foot & Ankle Center PA
- Northland Hearing Centers Inc.
- Novocardia Jacksonville ASC LLC
- Jessa Nowak
- Joan Nye
- Shea Kathleen O'Brien
All providers in Ponte Vedra, FL · Pediatric Adolescent Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.