Provider Demographics
NPI:1568659902
Name:PEDIATRICS CARE OF STUART,PA
Entity Type:Organization
Organization Name:PEDIATRICS CARE OF STUART,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIF
Authorized Official - Middle Name:
Authorized Official - Last Name:WAJID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-283-8890
Mailing Address - Street 1:509 SE RIVERSIDE DR
Mailing Address - Street 2:SUITE#300
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2579
Mailing Address - Country:US
Mailing Address - Phone:772-283-8890
Mailing Address - Fax:772-283-6946
Practice Address - Street 1:509 SE RIVERSIDE DR
Practice Address - Street 2:SUITE#300
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2579
Practice Address - Country:US
Practice Address - Phone:772-283-8890
Practice Address - Fax:772-283-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071221261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center