PEDIATRIC ASSOCIATES OF TAMPA BAY, LLC (NPI# 1912345497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912345497 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ASSOCIATES OF TAMPA BAY, LLC |
| Practice Address |
10710 State Road 54 Ste 108 Trinity FL 34655-2263 |
| Mailing Address |
900 S Pine Island Rd 800 Plantation FL 33324-3920 |
| Practice Telephone | 7273764040 |
| Practice Fax Number | 7273768824 |
| Mailing Telephone | 9549676400 |
| Mailing Fax Number | 9549657339 |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2020-08-25 |
| Authorized Official Name | DR. PETER J SHULMAN (CEO) |
| Authorized Official Telephone | 9549657322 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PEDIATRIC ASSOCIATES HOLDING COMPANY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008927601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855063 | Pediatric Associates of Tampa Bay, LLC | Pediatrics | 901 E Bloomingdale Ave # 501, Brandon, FL 33511-8118 | 2020-06-09 |
| 1861735383 | Pediatric Associates of Tampa Bay, LLC | Pediatrics | 900 S Pine Island Rd, #800, Plantation, FL 33324-3920 | 2013-04-03 |
| 1356904924 | Pediatric Associates of Tampa Bay, LLC | Pediatrics | 12871 Citrus Plaza Dr, Tampa, FL 33625-3010 | 2019-04-18 |
| 1447651179 | Pediatric Associates of Tampa Bay, LLC | Pediatrics | 7751 9th St N, St Petersburg, FL 33702-1102 | 2014-09-12 |
| Street Address |
10710 STATE ROAD 54 STE 108 |
| City | TRINITY |
| State | FL |
| Zip Code | 34655-2263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215908082 | Graciela F Egli | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655-2263 | 2006-01-30 |
| 1366892127 | Neelam Khaira | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655-2263 | 2016-06-13 |
| 1932586310 | Carleigh N Eldayrie | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655-2263 | 2015-05-05 |
| 1821418708 | Zsuzsanna G Scionti | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655 | 2014-04-18 |
| 1154640332 | Dayna C Moore | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655-2263 | 2010-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845221 | Kathryn E Wright | Social Worker | 8225 Florida State Road 54, New Port Richey, FL 34655 | 2020-09-15 |
| 1245873728 | Trinity Counseling Services | Marriage & Family Therapist | 1934 Duck Slough, Trinity, FL 34655 | 2019-10-28 |
| 1134770563 | Timothy Foster | Licensed Practical Nurse | 9332 Sr 54, Ste 202, Trinity, FL 34655 | 2019-09-26 |
| 1710542824 | Leah E. Grossman | Student in an Organized Health Care Education/Training Program | Medical Center of Trinity, 9330 State Rd 54, Trinity, FL 34655 | 2019-05-03 |
| 1508420696 | Varun Reddy | Student in an Organized Health Care Education/Training Program | 9330 Fl 54, Trinity, FL 34655 | 2019-04-24 |
| 1184183642 | Courtney Lynne Fagan | Specialist/Technologist | 8225 Fl-54, New Port Richey, FL 34655 | 2019-03-14 |
| 1164996633 | Brooke E Cox | Obstetrics & Gynecology | 8145 Cerebellum Way Ste 102, Trinity, FL 34655 | 2019-01-17 |
| 1144734591 | Optimal Performance and Physical Therapies Trinity LLC | Physical Therapist | 11157 Trinity Blvd, Trinity, FL 34655 | 2017-11-21 |
| 1629581285 | Nationwide Vision Center, LLC | Technician/Technologist | 3238 Little Rd, Trinity, FL 34655 | 2017-11-06 |
| 1053834267 | Spnn LLC | Pharmacy | 5429 Little Rd, New Port Richey, FL 34655 | 2017-07-19 |
| Find all providers in zip 34655 | ||||
| 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 |
|---|---|---|---|---|
| 1699792333 | Alexander H Gomez-luengas | Pediatrics | 10710 State Road 54, Suite 108, Trinity, FL 34655-2263 | 2006-07-17 |
| 1821014747 | Jay M Harvey | Pediatrics | 3012 Starkey Blvd, Trinity, FL 34655-2175 | 2006-07-14 |
| 1578519377 | Jessica Ilene Smith | Pediatrics | 2137 Little Rd, Trinity, FL 34655-4410 | 2006-05-25 |
| 1215908082 | Graciela F Egli | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655-2263 | 2006-01-30 |
| 1366892127 | Neelam Khaira | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655-2263 | 2016-06-13 |
| 1063874477 | Taylor Alberdi Bradley | Pediatrics | 10537 State Road 54, Trinity, FL 34655 | 2016-03-24 |
| 1932586310 | Carleigh N Eldayrie | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655-2263 | 2015-05-05 |
| 1821418708 | Zsuzsanna G Scionti | Pediatrics | 10710 State Road 54 Ste 108, Trinity, FL 34655 | 2014-04-18 |
| 1669771028 | Alisha Faye Pineiro | Pediatrics | 10710 State Road 54, Suite 108, Trinity, FL 34655-2263 | 2011-03-23 |
| 1578860078 | Personal Pediatric Care Pllc | Pediatrics | 3012 Starkey Blvd, Trinity, FL 34655-2175 | 2011-02-17 |
| Find all providers in TRINITY | ||||
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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.