First Coast Pediatric Infectious Disease LLC

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

ME89939 Issued in FL

Legal business name

FIRST COAST PEDIATRIC INFECTIOUS DISEASE LLC

Practice address

1555 Kingsley Ave
Ste. 201
Orange Park, FL 32073-4560

Phone

(904) 398-5614

Fax

(904) 398-5617

NPI assigned

Mar 23, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sebastian R Stanciu, MD

Title

Owner

Phone

(904) 398-5614

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1699137182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE",
            "address_2": "STE. 201",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734560",
            "telephone_number": "904-398-5614",
            "fax_number": "904-398-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE",
            "address_2": "STE. 201",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734560",
            "telephone_number": "904-398-5614",
            "fax_number": "904-398-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST PEDIATRIC INFECTIOUS DISEASE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "STANCIU",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-398-5614",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME89939",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "FL",
            "license": "ME89939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Medical Network LLC
• First Coast Medical, Inc
• First Coast Mental Health P a
• First Coast Obstetrics Associates, P.a.
• First Coast Optical LLC
• First Coast Podiatric Surgery and Wound Care LLC
• First Coast Psychiatric Services, P.a.
• First Senior Home Health IV, LLC
• Sarah Fishwild
• Five G Services LLC

• Pediatric Infectious Diseases Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Pediatric Infectious Diseases Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.