| Little Pine Pediatrics, Pllc | |
|
194 Ne Hancock Ave Madison FL 32340-2546 | |
| (850) 253-2275 | |
| (850) 253-2280 |
| Full Name | Little Pine Pediatrics, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 194 Ne Hancock Ave, Madison, Florida |
| Authorized Official Name and Position | Ronald Emerick (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 8502532275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Pine Pediatrics, Pllc 194 Ne Hancock Ave Madison FL 32340-2546 Ph: (850) 253-2275 | Little Pine Pediatrics, Pllc 194 Ne Hancock Ave Madison FL 32340-2546 Ph: (850) 253-2275 |
| NPI Number | 1043761539 |
|---|---|
| Provider Enumeration Date | 10/19/2016 |
| Last Update Date | 01/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043761539 | NPI | - | NPPES |
| 001165802 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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