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General NPI Number Information
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NPI Number | 1316385164
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Entity Type | Organization
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Legal Business Name | PEDIATRICA HEALTH OF FLORIDA, LLC
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 4788 HODGES BLVD SUITE B-108
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City | JACKSONVILLE
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State | FL
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Zip | 32224-7222
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Country | US
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Telephone | 904-223-9100
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Fax | 904-223-9282
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Provider Business Mailing Address
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Address Line | 75 VALENCIA AVE STE 709
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City | CORAL GABLES
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State | FL
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Zip | 33134-6132
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Country | US
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Telephone | 904-223-9100
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Fax | 904-223-9282
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Authorized Official
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Title or Position | OWNER/ DOCTOR
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Name | DR. PRASANTHI REDDY
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Credential | MD
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Telephone | 904-223-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | ME91195
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License Number State | FL
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