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

Pediatric Innovation Center, LLC

Organization Pediatrics Physician · NPI 1457805756

Pediatric Innovation Center, LLC is a Pediatrics Physician 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
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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