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DR. EMMANUEL PENA D.O. NPI 1063701274


NPI Information

NPI: 1063701274
Provider Name: DR. EMMANUEL PENA, D.O.
Classification: Pediatrics - 2080C0008X
Entity Type: Individual

Specialization: Child Abuse Pediatrics

PECOS Registration: Yes

Address:
841 PRUDENTIAL DR
SUITE 1130
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 603-4199
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DR. Emmanuel Pena, D.O. is a child abuse pediatrics pediatrics in Jacksonville, FL. The provider is a Child Abuse Pediatrician serves as a resource to children, families and communities by accurately diagnosing abuse; consulting with community agencies on child safety; providing expertise in courts of law; treating consequences of abuse and neglect; directing child abuse and neglect prevention programs and participating on multidisciplinary teams investigating; and managing child abuse cases. DR. Emmanuel Pena, D.O. NPI is 1063701274. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

841 PRUDENTIAL DR
SUITE 1130
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 603-4199
Fax: (904) 633-4188

The NPI 1063701274 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/29/2011 and was last updated on 6/7/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics11096AGEORGIANo
2208000000XPediatrics11096AWYOMINGNo
3208000000XPediatricsOS12734FLORIDANo
42080C0008XPediatricsChild Abuse Pediatrics80622GEORGIAYes
52080C0008XPediatricsChild Abuse PediatricsOS12734FLORIDANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.