MEDICARE: VOLUSIA PEDIATRICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134311640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOLUSIA PEDIATRICS, LLC

Provider Business Mailing Address
First Line	:	317 SOUTH DIXIE FREEWAY
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7158
Country	:	US
Telephone Number	:	386-424-1414
Fax Number	:	386-424-9130

Provider Business Practice Location Address
First Line	:	317 SOUTH DIXIE FREEWAY
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7158
Country	:	US
Telephone Number	:	386-424-1414
Fax Number	:	386-424-9130

Authorized Official
Title or Position	:	OWNER/MEDICAL DIRECTOR
Name	:	CRISTINA GARCIA-PILCHICK
Credential	:	MD
Telephone Number	:	386-424-1414

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	09/21/2011

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Directions to “VOLUSIA PEDIATRICS, LLC ” Practice Location

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