| NPI | 1295298818 |
|---|---|
| Doing Business As | LEGACY PEDIATRIC SERVICES |
| Entity Type | Organization |
| Authorized Contact | MAURICE REID CEO 863-589-8781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-04-10 |