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DE LA VEGA PEDIATRICS CORP. NPI 1790066983


NPI Information

NPI: 1790066983
Provider Name: DE LA VEGA PEDIATRICS, CORP.
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 10D2012851

Address:
12781 WORLD PLAZA LN STE 1
FORT MYERS, FL
ZIP 33907
Phone: (239) 277-5877
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DE LA VEGA PEDIATRICS, CORP. is a general practice in Fort Myers, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DE LA VEGA PEDIATRICS, CORP. NPI is 1790066983. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12781 WORLD PLAZA LN STE 1
FORT MYERS, FL
ZIP 33907-078
Phone: (239) 277-5877
Fax: (239) 277-1354

The provider's authorized official is Tatiana De La Vega .
The authorized official title is Office Manager and has the following contact phone number (239) 277-5877.

The CLIA number assigned to this NPI record is 10D2012851 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/1/2011 and was last updated on 3/25/2023.


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
1208000000XPediatricsME101292FLORIDANo
2208D00000XGeneral PracticeME101292FLORIDAYes

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

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