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General NPI Number Information
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NPI Number | 1891171914
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Entity Type | Organization
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Legal Business Name | HIGH SPRINGS PEDIATRICS LLC.
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 14900 NW 140TH ST
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City | ALACHUA
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State | FL
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Zip | 32615-6276
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Country | US
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Telephone | 386-418-0004
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Fax | 386-418-0033
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Provider Business Mailing Address
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Address Line | 14900 NW 140TH ST
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City | ALACHUA
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State | FL
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Zip | 32615-6276
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Country | US
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Telephone | 386-418-0004
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Fax | 386-418-0033
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. NASIR UDDIN AHMED
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Credential | M.D.
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Telephone | 386-454-1156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | ME97945
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License Number State | FL
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