MEDICARE: PARKSIDE PEDIATRICS, PLLC

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

General Provider Information

NPI Number	:	1548122278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKSIDE PEDIATRICS, PLLC

Provider Business Mailing Address
First Line	:	7301 LANCET LN
Second Line	:
City	:	NICHOLS HILLS
State	:	OK
Zip	:	73120-1400
Country	:	US
Telephone Number	:	405-446-7079
Fax Number	:	405-724-6917

Provider Business Practice Location Address
First Line	:	12038 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6807
Country	:	US
Telephone Number	:	405-724-5437
Fax Number	:	405-724-6917

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	DR. LAUREN GARABELLI
Credential	:	MD
Telephone Number	:	405-446-7079

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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