Provider Demographics
NPI:1194867390
Name:PEDIATRIX,INC
Entity Type:Organization
Organization Name:PEDIATRIX,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:CARZOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-393-7910
Mailing Address - Street 1:5229 RIVER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-4553
Mailing Address - Country:US
Mailing Address - Phone:904-745-3614
Mailing Address - Fax:904-308-2930
Practice Address - Street 1:4205 BELFORT RD
Practice Address - Street 2:4090
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1471
Practice Address - Country:US
Practice Address - Phone:904-296-7910
Practice Address - Fax:904-296-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1053912282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access