Healthcare Provider Details
I. General information
NPI: 1053502997
Provider Name (Legal Business Name): CARING PEDIATRICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2007
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4439 ROWAN ROAD
NEW PORT RICHEY FL
34653
US
IV. Provider business mailing address
4439 ROWAN ROAD
NEW PORT RICHEY FL
34653
US
V. Phone/Fax
- Phone: 727-853-2273
- Fax: 727-853-2277
- Phone: 727-853-2273
- Fax: 727-853-2277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AUDREY
URSULA
JARA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-853-2273