institution
Grace Pediatrics Pl
Pediatric Nurse Practitioner in Lake City, Florida
NPI 1720362429

Grace Pediatrics Pl is a Pediatric Nurse Practitioner based in Lake City, FL and is specialized in Pediatrics. Grace Pediatrics Pl practices in Lake City, FL. The NPI Number for Grace Pediatrics Pl is 1720362429 and holds a License No. 9220069 (Florida).

The current practice location address for Grace Pediatrics Pl is 4196 W Us Highway 90, Lake City, FL and can be reached out via phone at 386-243-8474 and via fax at 386-438-5945. You can also correspond with Grace Pediatrics Pl through the mailing address at 4196 W US HIGHWAY 90, LAKE CITY, FL - 32055-8834 (mailing address contact number: 386-243-8474).

Location: 4196 W Us Highway 90, Lake City, FL, 32055-8834
institution
Provider Profile Details
NPI Number
1720362429
Provider Name
Grace Pediatrics Pl
Credential
Provider Entity Type
Organization
Address
4196 W Us Highway 90, Lake City, FL, 32055-8834
Phone Number
386-243-8474
Fax Number
386-438-5945
Provider Enumeration Date
09/29/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004797600 05 FL
68-3810 01 FL MEDICARE RHC CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
4196 W Us Highway 90
City
State
Zip
32055-8834
Phone Number
386-243-8474
Fax Number
386-438-5945
person
Provider Business Mailing Address Details
Address
4196 W Us Highway 90
City
State
Zip
32055-8834
Phone Number
386-243-8474
Fax Number
386-438-5945
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
9220069 (Florida)
Definition
Definition to come...
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