Organization

Imagine Pediatrics Of Florida Llc

Legal Business Name

Imagine Pediatrics Of Florida Llc

NPI Number

1104542232

NPI Type

Organization

Enumeration Date

10/19/2022

Specialties

(Taxonomies)

Contact
Information

Purpose

Mailing
Location

Address

220 ATHENS WAY STE 240
3109 W DR MARTIN LUTHER KING JR BLVD STE 350

City

Nashville
Tampa

State

TN
FL

Postal Code

37228-1311
33607-6208

Country

US
US

Telephone Number

(504) 470-4140
(833) 208-7770

Authorized Official

Name

Kenneth Beery

Title or Position

CHIEF ADMIN. OFFICER (CAO)

Telephone Number

(504) 470-4140

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/06/2024

Provider Address