| NPI | 1174199137 |
|---|---|
| Doing Business As | ANGEL KIDS PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | AZZA GHANDOUR Billing/Credentialing Manager 904-242-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |