Healthcare Provider Details

I. General information

NPI: 1275198392
Provider Name (Legal Business Name): SPRING HILL PEDIATRIC CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 05/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11151 SPRING HILL DR
SPRING HILL FL
34609-4649
US

IV. Provider business mailing address

11151 SPRING HILL DR
SPRING HILL FL
34609-4649
US

V. Phone/Fax

Practice location:
  • Phone: 352-701-4030
  • Fax: 352-606-3149
Mailing address:
  • Phone: 352-701-4030
  • Fax: 352-606-3149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REGINALD B SAMPANG
Title or Position: PRESIDENT
Credential: MD
Phone: 352-701-4030