Provider Demographics
NPI:1922125160
Name:THE KIDS' HEALTH TEAM, P.A.
Entity Type:Organization
Organization Name:THE KIDS' HEALTH TEAM, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSI
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTUNATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-375-0001
Mailing Address - Street 1:6228 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-8871
Mailing Address - Country:US
Mailing Address - Phone:352-375-0001
Mailing Address - Fax:352-375-7897
Practice Address - Street 1:6228 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-8871
Practice Address - Country:US
Practice Address - Phone:352-375-0001
Practice Address - Fax:352-375-7897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty