PEDIATRIC CENTER FOR EXCELLENCE, LLC


Address: 13241 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5233
Phone: 9042245437

PEDIATRIC CENTER FOR EXCELLENCE, LLC (NPI# 1215434980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215434980
Entity Type Organization
Organization Name PEDIATRIC CENTER FOR EXCELLENCE, LLC
Practice Address 13241 Bartram Park Blvd Unit 209
Jacksonville
FL 32258-5233
Practice Telephone 9042245437
Practice Fax Number 9046742313
Mailing Telephone 9042245437
Mailing Fax Number 9046742313
Enumeration Date 2018-04-10
Last Update Date 2018-04-10
Authorized Official Name ASHRAF A AFFAN (OWNER)
Authorized Official Telephone 9042245437
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 225XP0200X Occupational Therapist
Specialization: Pediatrics
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
N 235Z00000X Speech-Language Pathologist Speech, Language and Hearing Service Providers
Y 2251P0200X Physical Therapist
Specialization: Pediatrics
Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 13241 BARTRAM PARK BLVD UNIT 209
City JACKSONVILLE
State FL
Zip Code 32258-5233

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831620210 Rebecca Hamilton Nurse Practitioner 13241 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5233 2017-03-27
1972067791 Gabriella Gisela Ford Physician Assistant 13241 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5233 2019-01-25
1659871762 Haley Danae Glasser Registered Nurse 13241 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5233 2018-02-15
1952834574 Noelle Vann Psychologist 13241 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5233 2017-04-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437794237 Nicoleta Descalzo Behavior Technician 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 2019-11-15
1992275572 William Lundgren Nurse Anesthetist, Certified Registered 3625 University Blvd South, Jacksonville, FL 32258 2018-11-27
1104301159 Emergency Physicians Inc Emergency Medicine 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 2018-09-26
1679092886 Palm Life Medical Associates Pa Assisted Living Facility 12494 Acosta Oaks Drive, Jacksonville, FL 32258 2017-09-19
1679013932 Optometry Vision Care Pllc Optometrist 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 2017-03-06
1467991950 North Florida Vision Group Inc Optometrist 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 2017-02-16
1124576566 Revolution Chiropractic LLC Chiropractor 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 2016-09-14
1396291936 Robyn Reaves Nurse Practitioner 12361 Richards Glen Ct, Jacksonville, FL 32258 2016-09-01
1326595927 Lauren Cost Chiropractor 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 2016-09-01
1487991170 Mark Steven Colosimo Pharmacist 13820 Old St Augustine Road, Jacksonville, FL 32258 2013-01-15
Find all providers in zip 32258

Taxonomy Information

Taxonomy Code 2251P0200X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Physical Therapist
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063957298 Intentional Play, Inc Physical Therapist 4712 Marsh Hammock Dr W, Jacksonville, FL 32224-1858 2016-12-26
1124101415 Elisabeth Federico Physical Therapist 3615 Oak St, Jacksonville, FL 32205-9021 2006-10-23
1013008838 All God's Children Therapy Center Physical Therapist 500 West Hickory, Jacksonville, AR 72076-3570 2006-09-27
1750373114 Eileen C Davies Physical Therapist 249 Orange Ave, Jacksonville, FL 32259-4215 2005-08-21
1467817239 Gregory Meyer Physical Therapist 2701 T P White Dr, Jacksonville, AR 72076-2514 2015-12-22
1003284316 Jessica Dailey Physical Therapist 12276 San Jose Blvd Ste 508, Jacksonville, FL 32223-8618 2015-09-03
1558775767 Jaimie Kuhn Zaharewicz Physical Therapist 7749 Normandy Blvd, Suite 147, Jacksonville, FL 32221-7657 2014-06-16
1124432604 Meghan Elizabeth Rowey Physical Therapist 3599 University Blvd S, Jacksonville, FL 32216-4251 2014-06-12
1144570169 Melissa Newman Physical Therapist 14785 Old Saint Augustine Rd, Jacksonville, FL 32258-2496 2012-09-17
1073832200 Rachel West Kempfert Physical Therapist 14785 Old Saint Augustine Rd, Jacksonville, FL 32258-2496 2010-05-27
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 32258

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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