| Longleaf Pediatrics Pa | |
|
103 Birch Ave Orange City FL 32763-7003 | |
| (386) 532-0800 | |
| (386) 532-7005 |
| Full Name | Longleaf Pediatrics Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 103 Birch Ave, Orange City, Florida |
| Authorized Official Name and Position | Valerie Celeste Burns (PEDIATRICIAN/OWNER) |
| Authorized Official Contact | 3865320800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longleaf Pediatrics Pa Po Box 740715 Orange City FL 32774-0715 Ph: (386) 532-0800 | Longleaf Pediatrics Pa 103 Birch Ave Orange City FL 32763-7003 Ph: (386) 532-0800 |
| NPI Number | 1114310851 |
|---|---|
| Provider Enumeration Date | 03/05/2015 |
| Last Update Date | 03/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114310851 | NPI | - | NPPES |
| 255837800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 255837800 (Florida) | Primary |
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