Provider Demographics
NPI:1053815431
Name:ADB MEDICAL SERVICES OF NORTH FLORIDA LLC
Entity Type:Organization
Organization Name:ADB MEDICAL SERVICES OF NORTH FLORIDA LLC
Other - Org Name:ASK PEDIATRIC SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:203-820-6692
Mailing Address - Street 1:3375 CAPITAL CIR NE BLDG D
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3778
Mailing Address - Country:US
Mailing Address - Phone:850-878-0229
Mailing Address - Fax:850-942-8537
Practice Address - Street 1:3375 CAPITAL CIR NE BLDG D
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-3778
Practice Address - Country:US
Practice Address - Phone:850-878-0229
Practice Address - Fax:850-942-8537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13611208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015893500Medicaid