DEOGRACIAS R PENA (NPI# 1669483855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669483855 |
| Entity Type | Individual |
| Full Name | DEOGRACIAS R PENA |
| Credential | MD |
| Practice Address |
615 E Princeton St Suite 401 Orlando FL 32803-1456 |
| Practice Telephone | 4073039311 |
| Practice Fax Number | 4073039273 |
| Mailing Telephone | 4073039311 |
| Mailing Fax Number | 4073039273 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2014-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
ME56326 | FL | Allopathic & Osteopathic Physicians |
| N | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
J9778 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBSTX GRP PIN | 00U87Z | 01 |
| TX | AMERIGROUP PIN | 10010075 | 01 |
| GRP NPI NUMBER | 1750369203 | 01 | |
| TX | BCBSTX PIN | 87Y112 | 01 |
| TX | AETNA PIN | 5056081 | 01 |
| TX | 133426012 | 05 | |
| TX | CIGNA PIN | 75208965 | 01 |
| TX | SUPERIOR PIN | 109517 | 01 |
| TX | FIRSTCARE PIN | 121266102 | 01 |
| TX | UHC PIN | 1443501 | 01 |
| Street Address |
615 E PRINCETON ST SUITE 401 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32803-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184627267 | Henry Pickett Dumas | Pediatrics | 615 E Princeton St, Ste 400, Orlando, FL 32803-1469 | 2005-05-23 |
| 1942722665 | Alyssa Brooks | Speech-Language Pathologist | 615 E Princeton St, Orlando, FL 32803-1456 | 2017-07-14 |
| 1558883256 | Susan Robins | Physical Therapist | 615 E Princeton St, Orlando, FL 32803-1456 | 2017-07-13 |
| 1376915140 | Monica V Urquiola | Nurse Practitioner | 615 E Princeton St, Suite 510, Orlando, FL 32803-1456 | 2015-10-20 |
| 1316341076 | Robin Denton | Physician Assistant | 615 E Princeton St, Suite 310, Orlando, FL 32803-1456 | 2014-10-09 |
| 1215280037 | Kristin Lea Hood Provencher | Nurse Practitioner | 615 E Princeton St, Suite 510, Orlando, FL 32803-1456 | 2012-10-17 |
| 1043562341 | Easter Johnson | Nurse Practitioner | 615 E Princeton St, Suite 225, Orlando, FL 32803-1456 | 2012-10-10 |
| 1902160070 | Moira Leah Al-malt | Registered Nurse | 615 E Princeton St, Suite 240, Orlando, FL 32803-1456 | 2012-07-03 |
| 1528374485 | Darren C Leach | Nurse Practitioner | 615 E Princeton St, Suite 101, Orlando, FL 32803-1435 | 2010-08-29 |
| 1376869529 | Joo Hee Seo | Psychiatry & Neurology | 615 E Princeton St, Suite 540, Orlando, FL 32803-1456 | 2010-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255952636 | Laiza Souza Tanner | Technician | 500 E Rollins St, Orlando, FL 32803 | 2020-04-27 |
| 1407415342 | Betty Carrol | Marriage & Family Therapist | 1516 E Colonial Dr Ste 100, Orlando, FL 32803 | 2019-06-12 |
| 1326606047 | Anthony Balingit | Physical Therapy Assistant | 1870 Aloma Avenue, Orlando, FL 32803 | 2019-05-29 |
| 1396234795 | Natasha Le Morvan | Technician/Technologist | 1364 Ferris Ave, Orlando, FL 32803 | 2018-05-02 |
| 1306365796 | Sarah E Fischer | Nurse Practitioner | Adventhealth Orlando, 601 E Rollins St, Orlando, FL 32803 | 2017-09-17 |
| 1710404249 | Emilia's Direct Care Agency | Community/Behavioral Health | 3218 E Colonial Dr Rm 118, Orlando, FL 32803 | 2017-08-25 |
| 1760907620 | Kalie Brianne Morris | Speech-Language Pathologist | 1120 Portland Ave Unit 7, Orlando, FL 32803 | 2017-08-11 |
| 1972024271 | Tatiana Ungredda | Psychologist | 5201 Raymond St Ste 424, Orlando, FL 32803 | 2017-06-28 |
| 1063942662 | Michael Thomas | Licensed Practical Nurse | 101 South Bumby Ave, E11, Orlando, FL 32803 | 2017-06-15 |
| 1598209249 | Danielle Marin | Behavioral Analyst | 2807 Edgewater Dr, Orlando, FL 32803 | 2016-12-15 |
| Find all providers in zip 32803 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| 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/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215965595 | Robert S. Mathias | Pediatrics | 1717 S. Orange Ave., Suite 100, Orlando, FL 32806-2946 | 2006-06-28 |
| 1487763645 | Norman Dale Pryor | Pediatrics | 203 Ernestine St, Ste A, Orlando, FL 32801-3621 | 2006-08-30 |
| 1609985464 | Brenda S. Montane | Pediatrics | 1717 S. Orange Ave., Suite 100 Nemours Childrens Clinic, Orlando, FL 32806-2946 | 2006-08-29 |
| 1013954635 | Orlando Health Inc | Pediatrics | 77 W Underwood St, Orlando, FL 32806-1122 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114301736 | Harold Marder | Pediatrics | 14030 Old Cypress Bnd, Palm Beach Gardens, FL 33410-1121 | 2015-07-14 |
| 1366715799 | Frank William Ayestaran Cassani | Pediatrics | 17 Davis Blvd Ste 200, Tampa, FL 33606-3438 | 2012-02-15 |
| 1356655187 | Omer Mansoor | Pediatrics | 5325 Greenwood Ave Ste 204, West Palm Beach, FL 33407-2452 | 2010-08-04 |
| 1174848378 | Jessica M Rodriguez | Pediatrics | 13101 Bruce B Dwn Blvd # 105, Tampa, FL 33612-3803 | 2010-03-30 |
| 1376552760 | Felix I. Ramirez-seijas | Pediatrics | 3200 Sw 60th Ct Ste 304, Miami, FL 33155-4071 | 2006-08-05 |
| 1629094735 | Irina F Gershin-stevens | Pediatrics | 15901 Bass Rd Ste 102, Fort Myers, FL 33908-3838 | 2006-07-14 |
| 1225060908 | Larry T Patterson | Pediatrics | 1600 Sw Archer Rd # 100296, Gainesville, FL 32610 | 2006-07-06 |
| 1437197373 | Reem Hussni Raafat | Pediatrics | 1131 N 35th Ave Ste 210, Hollywood, FL 33021 | 2006-06-03 |
| 1285671628 | Ivy Boydstun | Pediatrics | 1131 N 35th Ave Fl 2, Hollywood, FL 33021 | 2006-06-02 |
| 1922055615 | Ana L Paredes | Pediatrics | 6200 Sunset Dr Ste 303, South Miami, FL 33143-4829 | 2006-05-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DEOGRACIAS R PENA.
| 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.