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NPI Code Detail

MEDICARE: PEDIATRICS AT CAYDENS CORNER LLC

MEDICARE: PEDIATRICS AT CAYDENS CORNER 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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1710651112
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRICS AT CAYDENS CORNER LLC
Provider Business Mailing Address
First Line : 19800 TIMBERBLUFF DR
Second Line :
City : LAND O LAKES
State : FL
Zip : 34638-2602
Country : US
Telephone Number : 813-503-5004
Fax Number :
Provider Business Practice Location Address
First Line : 19800 TIMBERBLUFF DR
Second Line :
City : LAND O LAKES
State : FL
Zip : 34638-2602
Country : US
Telephone Number : 813-503-5004
Fax Number :
Authorized Official
Title or Position : OWNER/PROVIDER
Name : MRS. JULIANNA OSBORNE
Credential : APRN
Telephone Number : 813-790-9590
Provider Enumeration Date : 08/09/2021
Last Update Date : 08/27/2021

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Directions to “PEDIATRICS AT CAYDENS CORNER LLC ” Practice Location

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