PROFESSIONAL PEDIATRICS NPI 1992378202

NPI Information

NPI: 1992378202
Provider Name: PROFESSIONAL PEDIATRICS
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D2024451

Address:
1050 US HIGHWAY 27 STE 5
CLERMONT, FL
ZIP 34714
Phone: (352) 404-8944
Get Directions

PROFESSIONAL PEDIATRICS is a primary care clinic center in Clermont, FL. PROFESSIONAL PEDIATRICS NPI is 1992378202. The provider is registered as an organization entity type.

The provider's business location address is:

1050 US HIGHWAY 27 STE 5
CLERMONT, FL
ZIP 34714-508
Phone: (352) 404-8944

The provider's authorized official is Mohammad Afzal .
The authorized official title is Owner and has the following contact phone number (352) 394-3929.

The CLIA number assigned to this NPI record is 10D2024451 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/23/2021 and was last updated on 7/23/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

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
1	004770701	MEDICAID	FLORIDA

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

NPI Synchronization or Removal

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