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PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS INC NPI 1396805115


NPI Information

NPI: 1396805115
Provider Name: PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS INC

Doing Business As: PEDIM HEALTHCARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D2121835

Address:
1990 N PROSPECT AVE
LECANTO, FL
ZIP 34461
Phone: (352) 527-6888
Get Directions

PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS INC is a family medicine in Lecanto, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS INC NPI is 1396805115. The provider is registered as an organization entity type.
The provider Is Doing Business As Pedim Healthcare.

The provider's business location address is:

1990 N PROSPECT AVE
LECANTO, FL
ZIP 34461-792
Phone: (352) 527-6888
Fax: (352) 527-8818

The provider's authorized official is Dacelin St. Martin .
The authorized official title is Medical Director/owner and has the following contact phone number (352) 527-6888.

The CLIA number assigned to this NPI record is 10D2121835 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2006 and was last updated on 4/24/2023.


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
1261Q00000XClinic/Center10D1050573FLORIDANo
2261QS1200XClinic/CenterSleep Disorder DiagnosticNo
3207R00000XInternal MedicineNo
4208000000XPediatricsNo
5207Q00000XFamily MedicineYes

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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