| Williston Pediatrics, Inc | |
|
223 N Main St Williston FL 32696-2136 | |
| (352) 529-0477 | |
| (352) 529-0406 |
| Full Name | Williston Pediatrics, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 223 N Main St, Williston, Florida |
| Authorized Official Name and Position | Andrea M Quinlan (TREASURER) |
| Authorized Official Contact | 3525290477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Williston Pediatrics, Inc 223 N Main St Williston FL 32696-2136 Ph: (352) 529-0477 | Williston Pediatrics, Inc 223 N Main St Williston FL 32696-2136 Ph: (352) 529-0477 |
| NPI Number | 1326137001 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 10/28/2020 |
| Medicare PECOS PAC ID | 4486751914 |
|---|---|
| Medicare Enrollment ID | O20070517000676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326137001 | NPI | - | NPPES |
| 660141300 | Medicaid | FL | |
| 660141301 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Florida) | Primary |
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