LIGHTHOUSE PEDIATRICS PLLC NPI 1043630353

NPI Information

  • NPI: 1043630353
  • Provider Name: LIGHTHOUSE PEDIATRICS PLLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 10D2081536
  • Address: 100 WHETSTONE PL
    SUITE 211
    ST AUGUSTINE, FL
    ZIP 32086
  • Phone: (904) 342-7648

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NPI Details

LIGHTHOUSE PEDIATRICS PLLC is a pediatrics in St Augustine, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. LIGHTHOUSE PEDIATRICS PLLC NPI is 1043630353. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 WHETSTONE PL
SUITE 211
ST AUGUSTINE, FL
ZIP 32086-774
Phone: (904) 342-7648
Fax: (904) 342-8567

The provider's authorized official is Vincent Luz .
The authorized official title is Owner and has the following contact phone number (904) 342-7648.

The CLIA number assigned to this NPI record is 10D2081536 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/25/2014 and was last updated on 4/25/2014.

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
1208000000XPediatricsME90727FLORIDAYes

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: 11/21/2025

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