Edythe B. Park, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME100186 Issued in FL

Practice address

2725 SE Maricamp Rd
Ocala, FL 34471-5537

Phone

(352) 369-8700

Fax

(352) 369-8703

NPI assigned

Oct 31, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: edythe.park.1@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073699120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 S.E. MARICAMP ROAD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34471",
            "telephone_number": "352-369-8700",
            "fax_number": "352-369-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 SE MARICAMP RD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715537",
            "telephone_number": "352-369-8700",
            "fax_number": "352-369-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "EDYTHE",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME100186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME100186",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nina Paredes, DMD
• Parenting With Purpose
• Segismundo Pares, M.D.
• Inisha Parham, ARNP
• Park Dental of Ocala, PA
• Hyosun Park, ARNP
• Kyuwon Park, APRN
• Yewon Park
• Barbara L Parker, LPN, LMT
• Gregory A Parker, D.D.S.

• Pediatrics Physician in Ocala, FL
• Providers in Ocala, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.