Doctors Inlet Pediatrics and Primary Care

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DOCTORS INLET PEDIATRICS AND PRIMARY CARE

Practice address

10175 Fortune Pkwy Unit 401-402
Jacksonville, FL 32256

Phone

(904) 298-1994

Fax

(904) 298-1973

NPI assigned

Mar 8, 2016

Organization subpart

Yes

Parent organization

DOCTORS INLET PEDIATRICS & PRIMARY CARE, PAAs reported in NPPES

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

Authorized official

Name

Milind V Tilak, MD

Title

President

Phone

(904) 298-1994

Specialties & licenses 4

Addresses

Part of

Doctors Inlet Pediatrics and Primary Care

Locations

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1073974861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PARKWAY",
            "address_2": "SUITE 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566750",
            "telephone_number": "904-519-0008",
            "fax_number": "904-379-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 401-402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-298-1994",
            "fax_number": "904-298-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS INLET PEDIATRICS AND PRIMARY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOCTORS INLET PEDIATRICS & PRIMARY CARE, PA",
        "enumeration_date": "2016-03-08",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "TILAK",
        "authorized_official_first_name": "MILIND",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-298-1994",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.