Magnolia Pediatrics Llc

LBN: Magnolia Pediatrics Llc
Magnolia Pediatrics Llc is an health care organization with primary practice located at 1140 Sw Bascom Norris Dr Ste 104 , Lake City FL 32025-1329. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Magnolia Pediatrics Llc can be contacted via phone (386) 719-6500, or through Khodr, Bilal via phone (386) 719-6500.

Contact Information

Primary practice address
1140 Sw Bascom Norris Dr Ste 104 Lake City FL 32025-1329
Phone: (386) 719-6500
Fax: (386) 719-6503
Website:
Map and Directions
Authorized official contact:
Name: Khodr, Bilal Doctor of Medicine (MD)
Phone: (386) 719-6500

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME72652 Florida

Profile Details

NPI number 1356513964
LBN Legal business name Magnolia Pediatrics Llc
DBA Doing business as
Authorized official Khodr, Bilal Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 24th, 2008
Last updated Oct 5th, 2012 - about 12 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 1356513964 NPPES
Florida Other 061823792 TRICARE

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