Island Pediatrics of Islamorada PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME103085 Issued in FL

Legal business name

ISLAND PEDIATRICS OF ISLAMORADA PA

Practice address

81599 Old Hwy
Islamorada, FL 33036-3711

Phone

(305) 664-3384

NPI assigned

Nov 15, 2006

Last updated

Mar 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kristi Bengtson Bagnell, MD

Title

President

Phone

(305) 664-3384

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1124190764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81599 OLD HWY",
            "city": "ISLAMORADA",
            "state": "FL",
            "postal_code": "330363711",
            "telephone_number": "305-664-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81599 OLD HWY",
            "city": "ISLAMORADA",
            "state": "FL",
            "postal_code": "330363711",
            "telephone_number": "305-664-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND PEDIATRICS OF ISLAMORADA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "BAGNELL",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "BENGTSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-664-3384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME103085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devonne P Hall, LPN
• Rose Elizabeth Hewson-Hussey, ARNP
• Mark J. Hlis, O.D.
• Holiday CVS LLC (CVS Pharmacy 03788)
• Islamorada Village of Islands a Florida Municipality
• Nicholas Jastrzemski, PHARM.D., R.PH.
• Janis J Jeffers, DMD
• Keys Medical Center, Inc.
• Abrianna Rochelle Lawrence, PHARMD
• Pillar to Path Health, PLLC

• Pediatrics Physician in Islamorada, FL
• Providers in Islamorada, 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 18, 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.