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General NPI Number Information
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NPI Number | 1063557460
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ASSOCIATES AT ARGYLE PA
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 8351 WESTPORT RD
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City | JACKSONVILLE
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State | FL
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Zip | 32244-5901
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Country | US
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Telephone | 904-317-8811
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Fax | 904-317-4949
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Provider Business Mailing Address
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Address Line | 8351 WESTPORT RD
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City | JACKSONVILLE
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State | FL
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Zip | 32244-5901
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Country | US
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Telephone | 904-317-8811
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Fax | 904-317-4949
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RUBY RENDON
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Credential |
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Telephone | 904-317-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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