Provider Demographics
NPI:1669518072
Name:ALLIANCE PEDIATRICS PA
Entity type:Organization
Organization Name:ALLIANCE PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SARANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-335-8888
Mailing Address - Street 1:4627 NW 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4357
Mailing Address - Country:US
Mailing Address - Phone:352-335-8888
Mailing Address - Fax:352-335-9427
Practice Address - Street 1:4627 NW 53RD AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4357
Practice Address - Country:US
Practice Address - Phone:352-335-8888
Practice Address - Fax:352-335-9427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty