Angel Kids Pa

LBN: Angel Kids Pa
Angel Kids Pa is an health care organization with primary practice located at 13241 Bartram Park Blvd Suite 209, Jacksonville FL 32258. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Angel Kids Pa can be contacted via phone (904) 242-4220, or through Abu Affan, Ashraf A via phone (904) 242-4220.

Contact Information

Primary practice address
13241 Bartram Park Blvd Suite 209 Jacksonville FL 32258
Fax: (904) 674-2313
Website:
Authorized official contact:
Name: Abu Affan, Ashraf A Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1124162854
LBN Legal business name Angel Kids Pa
DBA Doing business as
Authorized official Abu Affan, Ashraf A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 16th, 2007
Last updated Jul 28th, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124162854 NPPES
Florida MEDICAID 270166900

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