Sanford Pediatric Associates Pa
Pediatric Adolescent Medicine
Sanford Pediatric Associates Pa is a Orange City, Florida based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
775 Harley Strickland Blvd, Suite 101, Orange City, Florida - 32763-7963. They can be contacted on phone at
386-851-0644 and fax number 386-851-0664.
NPI number (Unique professional ID) for Sanford Pediatric Associates Pa is
1124491816 which was assigned by NPPES on 04 Nov, 2015 and it was last updated on 04 Nov, 2015.
Sanford Pediatric Associates Pa license number is
ME0045959 for Pediatrics Adolescent Medicine (2080A0000X) in Florida.
Sanford Pediatric Associates Pa specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Sanford Pediatric Associates Pa basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Sanford Pediatric Associates Pa |
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Business Address:
Sanford Pediatric Associates Pa address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 775 Harley Strickland Blvd, Suite 101
Orange City, FL, 32763-7963
United States |
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| Phone Number : | 386-851-0644 |
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| Fax Number : | 386-851-0664 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1124491816 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 04 Nov, 2015 |
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| Last Updated On : | 04 Nov, 2015 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Johnedward Terwilleger |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | PRESIDENT |
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| Phone Number : | 386-851-0644 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Sanford Pediatric Associates Pa are as mentioned. Primary taxonomy code for Sanford Pediatric Associates Pa is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | ME0045959 | FL |
Legacy Identifiers:
Other legacy medical identifiers of Sanford Pediatric Associates Pa such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 044243700 | MEDICAID | FL | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 775 Harley Strickland Blvd, Suite 101
Orange City, FL, 32763-7963
United States |
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| Phone Number : | 386-851-0644 |
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| Fax Number : | 386-851-0664 |
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Business Location:
Patients can refer following map for directions to
Sanford Pediatric Associates Pa practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.