Healthcare Provider Details

I. General information

NPI: 1801502414
Provider Name (Legal Business Name): POCKET PEDIATRICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3253 SW 121ST WAY
GAINESVILLE FL
32608-0225
US

IV. Provider business mailing address

3253 SW 121ST WAY
GAINESVILLE FL
32608-0225
US

V. Phone/Fax

Practice location:
  • Phone: 727-457-0101
  • Fax:
Mailing address:
  • Phone: 727-457-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CARMELA M JONES
Title or Position: OWNER/DEVELOPMENTAL THERAPIST
Credential: RN
Phone: 727-457-0101