Organization Name: | KIDS FIRST PEDIATRIC CARE, PA |
NPI Number: | 1295044048 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TONI ALEXIS RICHARDS-ROWLEY (PRESIDENT) |
Mailing Address: | 4343 Lynx Paw Trl Valrico |
State: | FL US |
Postal Code: | 335967426 |
Phone Number: | 8136813800 |
Fax Number: | 8136813883 |
NPI Enumeration Date: | 09/28/2010 |
NPI Last Update Date: | 07/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | ME 85173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |