Community Care Pediatrics Pa

LBN: Community Care Pediatrics Pa
Community Care Pediatrics Pa is an health care organization with primary practice located at 3670 Us 1 South Ste 300 B , Saint Augustine FL 32086. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Community Care Pediatrics Pa can be contacted via phone (904) 479-9501, or through Anderson, Luis via phone (904) 479-9501.

Contact Information

Primary practice address
3670 Us 1 South Ste 300 B Saint Augustine FL 32086
Phone: (904) 479-9501
Fax: (904) 217-0524
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Luis Doctor of Medicine (MD)
Phone: (904) 479-9501

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1639437569
LBN Legal business name Community Care Pediatrics Pa
DBA Doing business as
Authorized official Anderson, Luis Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 28th, 2012
Last updated Feb 14th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639437569 NPPES
Florida MEDICAID 269304600

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