Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Pediatric Innovation Center, LLC

Organization Pediatrics Physician · NPI 1457805756

Pediatric Innovation Center, LLC provides Pediatrics Physician services in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2016.

Licensed in
FL
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13241 Bartram Park Blvd Ste 209
Jacksonville, FL 32258-5212 Not confirmed with CMS for 10 years — call before visiting
Phone: (904) 616-2772
Fax: (904) 674-2313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence ME86016 (FL)

Record details

NPI number1457805756
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashraf Affan — President · (904) 616-2772
NPI enumeratedAugust 4, 2016
Last updated in NPPESAugust 4, 2016
Mailing address13241 Bartram Park Blvd, Suite 209, Jacksonville, FL 32258-5212

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