Angel Kids PA

NPI #1174199137 in Jacksonville, Florida

Provider Information

NPI Number: 1174199137
Entity Type: Organization
Organization Name: Angel Kids PA
Primary Specialty: Pediatrics
Enumeration Date: Jun 1, 2021
Last Updated: Jun 1, 2021

Practice Location

Address: 13443 ATLANTIC BLVD
City: Jacksonville
State: Florida
ZIP Code: 32225-3131
Phone: (904) 242-4220

Authorized Official

Name: AZZA GHANDOUR
Title: BILLING/CREDENTIALING MANAGER
Phone: (904) 242-4220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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