NPIMap

Organization Active NPI

Florida Clinical Practice Association Inc

Doing business as UF Health Pediatrics - Magnolia Parke

  • Pediatrics Physician
  • Gainesville, FL
National Provider Identifier
1063850295
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Doing business as
UF Health Pediatrics - Magnolia Parke
Practice address
4740 NW 39TH PL
Ste B
Gainesville, FL 32606-7226
Phone
(352) 594-7337
Fax
(352) 265-5343
NPI assigned
Jun 10, 2013
Last updated
Nov 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Jeremy Sibiski
Title
Executive Vice President
Phone
(352) 265-8017

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

4740 NW 39TH PL
Ste B
Gainesville, FL 32606-7226

Mailing address

PO Box 13833
Philadelphia, PA 19101-3833

Other identifiers 1

IdentifierTypeStateIssuer
053386643MedicaidFL

Other names 1

  • UF Health Pediatrics - Magnolia Parke Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Salvatorer Goodwin MD33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1063850295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13833",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 NW 39TH PL",
            "address_2": "STE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067226",
            "telephone_number": "352-594-7337",
            "fax_number": "352-265-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA CLINICAL PRACTICE ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "SIBISKI",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "352-265-8017"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053386643",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UF Health Pediatrics - Magnolia Parke",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UF Health Pediatrics - Magnolia Parke",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.