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General NPI Number Information
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NPI Number | 1508343641
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Entity Type | Organization
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Legal Business Name | MILESTONES PEDIATRICS LLC
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Dates
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Enumeration Date | 07/21/2018
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 100 SW 75TH ST STE 101
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City | GAINESVILLE
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State | FL
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Zip | 32607-5775
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Country | US
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Telephone | 352-559-8911
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Fax | 352-559-8877
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Provider Business Mailing Address
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Address Line | 6910 NW 52ND LN
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City | GAINESVILLE
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State | FL
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Zip | 32653-3954
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Country | US
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Telephone | 352-559-8911
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Fax | 352-559-8877
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Authorized Official
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Title or Position | OWNER
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Name | PRIYANKA VYAS
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Credential |
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Telephone | 501-231-4079
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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 | ME116979
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License Number State | FL
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