Angel Kids PA

NPI #1386210367 in St Johns, Florida

Provider Information

NPI Number: 1386210367
Entity Type: Organization
Organization Name: Angel Kids PA
Primary Specialty: Pediatrics
Enumeration Date: Jun 1, 2021
Last Updated: Jun 1, 2021

Practice Location

Address: 774 STATE ROAD 13
City: St Johns
State: Florida
ZIP Code: 32259-3857
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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