TOTAL PEDIATRIC HEALTHCAREII (NPI# 1487880977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487880977 |
| Entity Type | Organization |
| Organization Name | TOTAL PEDIATRIC HEALTHCAREII |
| Practice Address |
930 Marcum Rd Lakeland FL 33809-4308 |
| Mailing Address |
5337 N Socrum Loop Rd 320 Lakeland FL 33809-4256 |
| Practice Telephone | 8638153775 |
| Practice Fax Number | 8638153765 |
| Mailing Telephone | 8638153775 |
| Mailing Fax Number | 8638153765 |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |
| Authorized Official Name | DR. STEWART A GRANT (PRESIDENT) |
| Authorized Official Telephone | 8638153775 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ME72163 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 41515 | 01 |
| FL | CITRUSCAID | 10880601 | 01 |
| CIGNA | 2321757001 | 01 | |
| FL | AETNA | 132800 | 01 |
| FL | AMERIGROUP | 01106700 | 01 |
| FL | 268531100 | 05 | |
| WELLCARE | 225385 | 01 |
| Street Address |
930 MARCUM RD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33809-4308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003049990 | Adelene Soto | Nurse Practitioner | 930 Marcum Rd, Lakeland, FL 33809-4308 | 2009-08-26 |
| 1932359486 | Karina Ivon Auza De Ryvnine | Physician Assistant | 930 Marcum Rd, Suite 12, Lakeland, FL 33809-4308 | 2008-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861018178 | John C Gallik | Military Health Care Provider | 3176 Corporal Johnson Road, Jbsa Fort Sam Houston, TX 33809 | 2020-06-23 |
| 1376189209 | Julie Independence Tomchak | Nurse's Aide | 7805 Us Highway Lot 29 # 98 N, Lakeland, FL 33809 | 2019-11-26 |
| 1912465923 | Lakeland Oaks Nh LLC | Skilled Nursing Facility | 855 Carpenters Way, Lakeland, FL 33809 | 2019-03-08 |
| 1235528753 | Christia Mccann | Physician Assistant | 4120 Us Hwy. 98 N., One Lakeland Square, Lakeland, FL 33809 | 2015-01-21 |
| 1548679616 | Ashley Frances Hamarowicz | Physical Therapist | 771 Carpenters Way, Lakeland, FL 33809 | 2014-08-04 |
| 1750700860 | Grace Manor Suites | Assisted Living Facility | 4620 N Socrum Loop Road, Lakeland, FL 33809 | 2014-04-16 |
| 1164769980 | Christopher Fisher | Hearing Instrument Specialist | 3800 North Rd 98, Ste 500, Lakeland, FL 33809 | 2013-01-14 |
| 1023374063 | Eagle Lake Pharmacy Inc | Pharmacy | 5245 A U S Hwy 98 N, Suite A, Lakeland, FL 33809 | 2012-04-04 |
| 1851669675 | Reginald Keith Jenkins | Pharmacist | 1043 Walt Williams Road, Lakeland, FL 33809 | 2011-12-07 |
| 1578859633 | Jill Margaret Waldrop | Pharmacist | 6600 N. Socrum Loop, Lakeland, FL 33809 | 2011-06-27 |
| Find all providers in zip 33809 | ||||
| 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 |
|---|---|---|---|---|
| 1134490204 | Theresa Lynn Felten | Pediatrics | 223 Lake Gibson Ln, Lakeland, FL 33809-3545 | 2012-01-22 |
| 1336469931 | Cara Marjorie Anne Cannon | Pediatrics | 5950 South Florida Ave., Lakeland, FL 33813-2532 | 2010-06-04 |
| 1134446107 | Urquiza Pediatrics | Pediatrics | 1545 Lakeland Hills Blvd, Lakeland, FL 33805-3246 | 2010-04-29 |
| 1235385287 | Mark Friberg | Pediatrics | 430 E Central Avenue, Lakeland, FL 33805 | 2008-08-11 |
| 1467521161 | Deborah Kathleen Ford | Pediatrics | 5705 Us Highway 98 S, Lakeland, FL 33812-4108 | 2006-11-07 |
| 1356351019 | Hugh W Johnson | Pediatrics | 2515 Troy Ave, Bay Area Primary Care Assoc Inc, Lakeland, FL 33803-2960 | 2006-08-08 |
| 1518973973 | Lakeside Pediatrics North | Pediatrics | 2929 Lakeland Hills Blvd, Lakeland, FL 33805-2223 | 2006-07-31 |
| 1477519155 | Daniel L Leviten | Pediatrics | 5950 S Florida Ave, Lakeland, FL 33813-2532 | 2006-04-22 |
| 1558335760 | Dorothy Joan Ray | Pediatrics | 2140 E Edgewood Dr, Lakeland, FL 33803-3604 | 2006-02-14 |
| 1114907417 | Karen Beth Schick | Pediatrics | 601 S Florida Ave, Suite 6, Lakeland, FL 33801-5237 | 2006-01-20 |
| Find all providers in LAKELAND | ||||
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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.