OrganizationActive
Angel Kids PA
NPI 1174199137 · Pediatrics Physician · Jacksonville, FL
Provider details
- NPI number
- 1174199137
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Azza Ghandour, Billing/Credentialing Manager(904) 242-4220
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
13443 Atlantic Blvd
Jacksonville, FL 32225-3131
Phone: (904) 242-4220
Street-level locationGet directions
Mailing address
13241 Bartram Park Blvd Unit 209
Jacksonville, FL 32258-5233
Other names (DBA / former)
- Doing business as
- Angel Kids Pediatrics
Registry dates
- Enumerated
- 2021-06-01
- Last updated
- 2021-06-01
- Certified
- 2021-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.