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General NPI Number Information
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NPI Number | 1629507579
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Entity Type | Organization
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Legal Business Name | ALL ABOUT PEDIATRICS, LLC
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 1020 W MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32805-5447
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Country | US
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Telephone | 904-240-4555
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Fax | 904-272-9080
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Provider Business Mailing Address
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Address Line | 532 SAMPLES ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-2765
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Country | US
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Telephone | 904-240-4555
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Fax | 904-272-9080
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Authorized Official
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Title or Position | OWNER/CFO
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Name | MARSHA ANNE BERG
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Credential |
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Telephone | 904-629-3197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1313693
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License Number State | FL
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