Organization Active NPI

Pediatric &Adolescent Medicine

  • Pediatric Adolescent Medicine Physician
  • Hialeah, FL
National Provider Identifier
1154712198
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
ME0063187 Issued in FL
Legal business name
PEDIATRIC &ADOLESCENT MEDICINE
Doing business as
Pediatric &Adolescent Medicine
Practice address
7150 W 20TH Ave Ste 612
Hialeah, FL 33016-5534
Phone
(305) 827-1561
NPI assigned
Feb 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Authorized official

Name
Dr. Robert Bellamine O'Neill, M.D.NPI 1205810439
Title
Doctor
Phone
(305) 827-1561

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
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X ME0063187 FL Primary

Addresses

Primary practice location

7150 W 20TH Ave Ste 612
Hialeah, FL 33016-5534

Mailing address

7150 W 20TH Ave Ste 612
Hialeah, FL 33016-5534
Phone (305) 827-1561

Other identifiers 1

IdentifierTypeStateIssuer
372063200MedicaidFL

Other names 1

  • Pediatric &Adolescent Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Adolescent Medicine2 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.

Practitioners & affiliated clinicians

Practitioners 2

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": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1154712198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 W 20TH AVE STE 612",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165534",
            "telephone_number": "305-827-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 W 20TH AVE STE 612",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165534",
            "telephone_number": "305-827-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC &ADOLESCENT MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BELLAMINE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "305-827-1561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME0063187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372063200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric &Adolescent Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.