Provider Demographics
NPI:1710295514
Name:SANDCASTLES PEDIATRIC RECORDS SERVICES
Entity Type:Organization
Organization Name:SANDCASTLES PEDIATRIC RECORDS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:GARCIA-KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-324-8516
Mailing Address - Street 1:506 S.W. FEDERAL HWAY 1
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994
Mailing Address - Country:US
Mailing Address - Phone:772-324-8516
Mailing Address - Fax:772-324-8518
Practice Address - Street 1:506 S.W. FEDERAL HIGHWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994
Practice Address - Country:US
Practice Address - Phone:772-324-8516
Practice Address - Fax:772-324-8518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty