| South Manatee Pediatrics | |
|
5108 15th St E Ste 111 Bradenton FL 34203-4844 | |
| (941) 210-7942 | |
| Not Available |
| Full Name | South Manatee Pediatrics |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5108 15th St E Ste 111, Bradenton, Florida |
| Authorized Official Name and Position | Melvin B Price (PRESIDENT/CEO) |
| Authorized Official Contact | 9417764000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Manatee Pediatrics 101 Riverfront Blvd Ste 710 Bradenton FL 34205-8812 Ph: (941) 776-4000 | South Manatee Pediatrics 5108 15th St E Ste 111 Bradenton FL 34203-4844 Ph: (941) 210-7942 |
| NPI Number | 1164018453 |
|---|---|
| Provider Enumeration Date | 12/21/2020 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164018453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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