SUMTER PEDIATRICS PA NPI 1174924757

NPI Information

NPI: 1174924757
Provider Name: SUMTER PEDIATRICS PA
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 10D2084869

Address:
265 CITRUS TOWER BLVD STE 102
CLERMONT, FL
ZIP 34711
Phone: (352) 394-3929
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SUMTER PEDIATRICS PA is a rural health clinic center in Clermont, FL. SUMTER PEDIATRICS PA NPI is 1174924757. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

265 CITRUS TOWER BLVD STE 102
CLERMONT, FL
ZIP 34711-908
Phone: (352) 394-3929
Fax: (352) 394-6446

The provider's authorized official is Mohammad Afzal .
The authorized official title is Doctor and has the following contact phone number (352) 394-3929.

The CLIA number assigned to this NPI record is 10D2084869 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/15/2014 and was last updated on 11/2/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		ME72542	FLORIDA	No
2	261QR1300X	Clinic/Center	Rural Health	ME72542	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	014683500	MEDICAID	FLORIDA
2	260332200	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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