NPIMap

Organization Active NPI

Pediatric Urgent Care Group of Ormond Beach

  • Urgent Care Clinic/Center
  • Ormond Beach, FL
National Provider Identifier
1083831192
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PEDIATRIC URGENT CARE GROUP OF ORMOND BEACH
Practice address
1688 W Granada Blvd
Suite 1a
Ormond Beach, FL 32174-1851
Phone
(386) 615-4414
Fax
(386) 615-8466
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Dr. Jaime E Quinteros, MDNPI 1649354747
Title
President
Phone
(386) 615-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1688 W Granada Blvd
Suite 1a
Ormond Beach, FL 32174-1851

Mailing address

1688 W Granada Blvd
Suite 1a
Ormond Beach, FL 32174-1851
Phone (386) 615-4414

Other names 1

  • Twilight Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Urgent Care Group of Ormond Beach2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1083831192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1688 W GRANADA BLVD",
            "address_2": "SUITE 1A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741851",
            "telephone_number": "386-615-4414",
            "fax_number": "386-615-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1688 W GRANADA BLVD",
            "address_2": "SUITE 1A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741851",
            "telephone_number": "386-615-4414",
            "fax_number": "386-615-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC URGENT CARE GROUP OF ORMOND BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "QUINTEROS",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-615-4414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twilight Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.