Ped-E-Care

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

60080992 Issued in FL

Legal business name

PED-E-CARE

Doing business as

PARC Place

Practice address

540 State Road 13
Suite 104
Fruit Cove, FL 32259-3872

Phone

(904) 814-8209

NPI assigned

Sep 3, 2010

Last updated

Sep 3, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jane T Park, RN

Title

Director of Nursing

Phone

(904) 608-4688

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PARC Place Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1003123696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 STATE ROAD 13",
            "address_2": "SUITE 104",
            "city": "FRUIT COVE",
            "state": "FL",
            "postal_code": "322593872",
            "telephone_number": "904-814-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 STATE ROAD 13",
            "address_2": "SUITE 104",
            "city": "FRUIT COVE",
            "state": "FL",
            "postal_code": "322593872",
            "telephone_number": "904-814-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PED-E-CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-03",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "904-608-4688",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "60080992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPEC LICENSE NUMBER",
            "identifier": "60080992",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARC Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kiera Miller, PT, DPT
• Sayward Brett Minter, LPN
• Carol Elizabeth Neumann
• North Florida Pediatrics PA
• Ross Quinn Osborn, M.D.
• Madison Stalls, DNP
• Raquel Stelzer, APRN
• Michaele Bailey Suarez, DC
• The Playful Family, Inc.
• Lisa D Vargo, LCSW

• Nursing Care Agency in Fruit Cove, FL
• Providers in Fruit Cove, FL by specialty
• Nursing Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.