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PENINSULA PEDIATRICS OF WEST FLORIDA PLLC NPI 1639538713


NPI Information

NPI: 1639538713
Provider Name: PENINSULA PEDIATRICS OF WEST FLORIDA, PLLC

Doing Business As: PENINSULA PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D2112675

Address:
13163 66TH STREET
LARGO, FL
ZIP 33773
Phone: (727) 228-7000
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PENINSULA PEDIATRICS OF WEST FLORIDA, PLLC is a pediatrics in Largo, 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. PENINSULA PEDIATRICS OF WEST FLORIDA, PLLC NPI is 1639538713. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Peninsula Pediatrics.

The provider's business location address is:

13163 66TH STREET
LARGO, FL
ZIP 33773
Phone: (727) 228-7000
Fax: (727) 223-3614

The provider's authorized official is Steven Michael Moore .
The authorized official title is Owner and has the following contact phone number (727) 228-7000.

The CLIA number assigned to this NPI record is 10D2112675 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2016 and was last updated on 6/5/2023.


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
1208000000XPediatricsME 100692FLORIDAYes

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
1018367100MEDICAIDFLORIDA

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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