| Kids And Families Medical Clinic Llc | |
|
12086 Fort Caroline Rd Ste 404 Jacksonville FL 32225-7640 | |
| (904) 300-6248 | |
| Not Available |
| Full Name | Kids And Families Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12086 Fort Caroline Rd Ste 404, Jacksonville, Florida |
| Authorized Official Name and Position | Kia Mitchell (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9043006248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids And Families Medical Clinic Llc 12086 Fort Caroline Rd Ste 404 Jacksonville FL 32225-7640 Ph: (904) 747-3800 | Kids And Families Medical Clinic Llc 12086 Fort Caroline Rd Ste 404 Jacksonville FL 32225-7640 Ph: (904) 300-6248 |
| NPI Number | 1891359998 |
|---|---|
| Provider Enumeration Date | 04/24/2019 |
| Last Update Date | 06/09/2020 |
| Medicare PECOS PAC ID | 8820419328 |
|---|---|
| Medicare Enrollment ID | O20200610000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891359998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0000X | Family Medicine - Adolescent Medicine | (* (Not Available)) | Primary |
| 2080P0205X | Pediatrics - Pediatric Endocrinology | (* (Not Available)) | Secondary |
| Provider Name | Kia Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184602583 PECOS PAC ID: 1052346657 Enrollment ID: I20051003000506 |
| Provider Name | Thanh M Nguyen |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1831296656 PECOS PAC ID: 8921139338 Enrollment ID: I20100629000659 |
| Provider Name | William Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467693358 PECOS PAC ID: 4789810771 Enrollment ID: I20131121001467 |
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