OrganizationActive
Magnolia Pediatrics LLC
NPI 1356513964 · Pediatrics Physician · Lake City, FL
Magnolia Pediatrics LLC is a Pediatrics Physician organization in Lake City, FL (NPI 1356513964).
Provider details
- NPI number
- 1356513964
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Bilal Khodr, Provider(386) 719-6500
- License
- ME72652 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
1140 Sw Bascom Norris Dr Ste 104
Lake City, FL 32025-1329
Phone: (386) 719-6500
Fax: (386) 719-6503
Street-level locationGet directions
Mailing address
1140 Sw Bascom Norris Dr Ste 104
Lake City, FL 32025-1329
Registry dates
- Enumerated
- 2008-03-24
- Last updated
- 2012-10-05
Frequently asked questions
- What is Magnolia Pediatrics LLC's NPI number?
- Magnolia Pediatrics LLC's National Provider Identifier (NPI) is 1356513964, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Magnolia Pediatrics LLC?
- Magnolia Pediatrics LLC is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Magnolia Pediatrics LLC located?
- Magnolia Pediatrics LLC's practice location on file with NPPES is 1140 Sw Bascom Norris Dr Ste 104, Lake City, FL 32025-1329.
- What is Magnolia Pediatrics LLC's phone number?
- The practice phone number listed in the NPPES registry for Magnolia Pediatrics LLC is (386) 719-6500.
- Who is the authorized official for Magnolia Pediatrics LLC?
- The authorized official listed on Magnolia Pediatrics LLC's NPPES record is Bilal Khodr, Provider. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Magnolia Pediatrics LLC's NPI active?
- Yes — Magnolia Pediatrics LLC's NPI (1356513964) is active in the NPPES registry as of the last update on 2012-10-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.