MAGNOLIA PEDIATRICS LLC
Medical Practice at Bascom Norris Dr, Lake City, FL

License number
Florida ME72652
Category
Medical Practice
Type
Pediatrics
Owner
Name: DR. BILAL KHODR MD
Title: PROVIDER
Phone: (386) 719-6500
Address
Address
1140 SW Bascom Norris Dr STE 104, Lake City, FL 32025
National Provider ID: 1356513964
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about MAGNOLIA PEDIATRICS LLC at bizstanding.com

Magnolia Pediatrics, LLC

Lake City, FL

Industry:
Medical Doctor's Office
Registration:
Aug 29, 2007
Addresses:
112 SW Partridge Ct, Lake City, FL 32025
1140 SW Bascom Norris Dr, Lake City, FL 32025
State ID:
L07000089019
Business type:
Florida Limited Liability
Managing Members:
Stacey Cervantes (Managing Member),Stephanie Finnell Managing Member, inactive,Stacey Cervates Managing Member, inactive
Agent:
Jack Muenchen

Magnolia Pediatrics, LLC

4424 NW American Ln, Lake City, FL 32055

Industry:
Medical Doctor's Office
Principals:
Bilal Khodr (Medical Doctor),Stacey Cervantes (Principal),Cathrin J. Smith Principal, inactive

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