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GAINESVILLE PEDIATRIC MEDICINE PA NPI 1447495338


NPI Information

NPI: 1447495338
Provider Name: GAINESVILLE PEDIATRIC MEDICINE, PA
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D1097799

Address:
1131 NW 64 TERRACE
SUITE B
GAINESVILLE, FL
ZIP 32605
Phone: (352) 332-9940
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GAINESVILLE PEDIATRIC MEDICINE, PA is a pediatrics in Gainesville, 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. GAINESVILLE PEDIATRIC MEDICINE, PA NPI is 1447495338. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1131 NW 64 TERRACE
SUITE B
GAINESVILLE, FL
ZIP 32605-600
Phone: (352) 332-9940
Fax: (352) 332-9939

The provider's authorized official is Valerie Numssen .
The authorized official title is President and has the following contact phone number (352) 332-9940.

The CLIA number assigned to this NPI record is 10D1097799 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/8/2008 and was last updated on 12/19/2008.


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
1208000000XPediatricsME79357FLORIDANo
2208000000XPediatricsME78807FLORIDAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H25793MEDICARE UPINFLORIDA
2032026900MEDICAIDFLORIDA
32680OTHERFLORIDABCBS
4032025100MEDICAIDFLORIDA

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

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