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ELITE PEDIATRIC HEALTHCARE LLC NPI 1962000174


NPI Information

NPI: 1962000174
Provider Name: ELITE PEDIATRIC HEALTHCARE, LLC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

CLIA Number: 10D2222898

Address:
673 S KINGS AVENUE
BRANDON, FL
ZIP 33511
Phone: (251) 610-5615
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ELITE PEDIATRIC HEALTHCARE, LLC is a pediatrics nurse practitioner in Brandon, FL. ELITE PEDIATRIC HEALTHCARE, LLC NPI is 1962000174. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

673 S KINGS AVENUE
BRANDON, FL
ZIP 33511
Phone: (251) 610-5615

The provider's authorized official is Rhonda Nichols Mcgrew .
The authorized official title is Nurse Practitioner/co-owner and has the following contact phone number (251) 610-5615.

The CLIA number assigned to this NPI record is 10D2222898 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2020 and was last updated on 5/8/2021.


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
1363LP0200XNurse PractitionerPediatricsYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.