KIDSVILLE PEDIATRICS III, P.A. (NPI# 1215901723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215901723 |
| Entity Type | Organization |
| Organization Name | KIDSVILLE PEDIATRICS III, P.A. |
| Practice Address |
1804 Oakley Seaver Blvd Suite-c Clermont FL 34711-1925 |
| Practice Telephone | 3522421021 |
| Practice Fax Number | 3522421104 |
| Mailing Telephone | 3522421021 |
| Mailing Fax Number | 3522421104 |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2019-08-08 |
| Authorized Official Name | MR. VICTOR M. PANTOJA JR. (ADMINISTRATOR) |
| Authorized Official Telephone | 3522421021 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ME-0074421 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | FL206A | 01 |
| FL | 001599400 | 05 |
| Street Address |
1804 OAKLEY SEAVER BLVD SUITE-C |
| City | CLERMONT |
| State | FL |
| Zip Code | 34711-1925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982619417 | Clermont Radiology LLC | Physiological Laboratory | 1804 Oakley Seaver Blvd, Suite B, Clermont, FL 34711-1925 | 2006-07-31 |
| 1487620993 | Christopher James Johnson | Surgery | 1804 Oakley Seaver Blvd, Suite A, Clermont, FL 34711-1925 | 2006-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546344 | Latricia Richards-smith | Nurse Practitioner | 3301 Hancock Rd, Clermont, FL 34711 | 2020-10-21 |
| 1073130399 | Marissa Johnston | Behavioral Analyst | 355 Citrus Tower Blvd Ste 112, Clermont, FL 34711 | 2020-07-02 |
| 1649839432 | New Foundations Aba Therapy, LLC | Community/Behavioral Health | 4327 S Hwy 27 #176 Clermont, Clermont, FL 34711 | 2019-06-06 |
| 1275006504 | Innovative Medical Management Solutions LLC | Skilled Nursing Facility | 1775 Hooks Street, Clermont, FL 34711 | 2019-01-09 |
| 1851867766 | Chantal P Baptiste | Nurse Practitioner | 2040 Oakley Seaver Dr Ste 300, Clermont, FL 34711 | 2018-10-17 |
| 1346739539 | Jennifer Brennan | Behavior Technician | 365 Citrus Tower Blvd Bldg Ste 106, Clermont, FL 34711 | 2018-05-03 |
| 1689163966 | Chelsea Strickland | Physical Therapy Assistant | 10037 Stockbridge St, Clermont, FL 34711 | 2018-05-02 |
| 1316448921 | Dana Renee Ottalagano | Counselor | 1635 E Highway 50 Ste 204, Clermont, FL 34711 | 2018-02-28 |
| 1306353842 | Center of Change Inc. | General Practice | 235 Citrus Tower Blvd Ste 104, Clermont, FL 34711 | 2018-01-05 |
| 1003328642 | Clermont Radiology LLC | Clinic/Center | 3725 South Highway 27, Suite 104, Clermont, FL 34711 | 2017-11-03 |
| Find all providers in zip 34711 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528625241 | Advocare, LLC | Pediatrics | 2041 Route 9 North, Clermont, NJ 08210 | 2019-05-29 |
| 1174924757 | Sumter Pediatrics Pa | Pediatrics | 265 Citrus Tower Blvd Ste 102, Clermont, FL 34711-1908 | 2014-09-15 |
| 1992131080 | Bennett Pediatrics, LLC | Pediatrics | 365 Citrus Tower Blvd, Suite 104, Clermont, FL 34711-6532 | 2013-09-19 |
| 1922354927 | Cesar Ramiro Mejia | Pediatrics | 17325 Pagonia Dr, Clermont, FL 34711-6008 | 2012-07-27 |
| 1689883431 | Shahrzad Tarafdar Haghighat | Pediatrics | 861 Oakley Seaver Dr, Clermont, FL 34711-1968 | 2007-05-21 |
| 1124194980 | Morgan Jenkins | Pediatrics | 16709 Kamalin Ct, Clermont, FL 34715-9519 | 2006-11-24 |
| 1861577694 | Jamil H Khan | Pediatrics | 1528 Sunrise Plaza Dr, Suite One, Clermont, FL 34714-6205 | 2006-10-27 |
| 1285675330 | Lorna Odette Bennett | Pediatrics | 365 Citrus Tower Blvd Ste 104, Clermont, FL 34711-6532 | 2006-06-09 |
| 1669411161 | Mohammad Afzal | Pediatrics | 265 Citrus Tower Blvd, Ste 102, Clermont, FL 34711-1908 | 2006-06-06 |
| 1235199464 | Christine Chan-ragazzo | Pediatrics | 1371 Citrus Tower Blvd, Nemours Childrens Primary Care, Clermont, Clermont, FL 34711-1924 | 2006-03-23 |
| Find all providers in CLERMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.