PALM BAY PEDIATRICS NPI 1770731291

NPI Information

  • NPI: 1770731291
  • Provider Name: PALM BAY PEDIATRICS
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 10D2055018
  • Address: 775 MALABAR RD
    MALABAR, FL
    ZIP 32950
  • Phone: (321) 722-8435

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NPI Details

PALM BAY PEDIATRICS is a pediatrics in Malabar, 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. PALM BAY PEDIATRICS NPI is 1770731291. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

775 MALABAR RD
MALABAR, FL
ZIP 32950-120
Phone: (321) 722-8435
Fax: (321) 722-8486

The provider's authorized official is Doris Margarita Leedy .
The authorized official title is Owner/physician and has the following contact phone number (321) 722-8435.

The CLIA number assigned to this NPI record is 10D2055018 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2008 and was last updated on 9/9/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0205XPediatricsPediatric EndocrinologyME63747FLORIDANo
2208000000XPediatricsME63747FLORIDAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E41429OTHERFLORIDAUPIN
2=========OTHERFLORIDAHEALTHFIRST
3372797100MEDICAIDFLORIDA
4632833OTHERFLORIDAAETNA
53736201002OTHERFLORIDACIGNA
6=========OTHERFLORIDAUNITEDHEALTHCARE
7=========OTHERFLORIDATAX ID NUMBER
818683OTHERFLORIDABLUE CROSS BLUE SHIELD

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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