Pediatric Surgery P.a.

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

Legal business name

PEDIATRIC SURGERY P.A.

Practice address

1220 Sligh Blvd
Orlando, FL 32806-1108

Phone

(407) 228-4774

Fax

(407) 228-2128

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Mark S Chaet, MD

Title

President

Phone

(407) 228-4774

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1023039351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SLIGH BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061108",
            "telephone_number": "407-228-4774",
            "fax_number": "407-228-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SLIGH BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061108",
            "telephone_number": "407-228-4774",
            "fax_number": "407-228-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SURGERY P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "CHAET",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-228-4774",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253269700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.