Kidz General Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KIDZ GENERAL PEDIATRICS

Practice address

9200 Bonita Beach Rd SE Ste 106
Bonita Springs, FL 34135-4254

Phone

(239) 213-0690

Fax

(239) 552-4060

NPI assigned

Oct 22, 2018

Organization subpart

No

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

Authorized official

Name

Irene Navarro

Title

HR/Credentialing Specialist

Phone

(305) 661-1515

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1174099717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE STE 106",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354254",
            "telephone_number": "239-213-0690",
            "fax_number": "239-552-4060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Ponce De Leon Blvd",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331462423",
            "country_code": "US",
            "telephone_number": "305-661-1515 x243",
            "fax_number": "305-662-3723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIDZ GENERAL PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "HR/CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "305-661-1515"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ketamine Health Centers at Bonita Springs, LLC
• Daniela Ketay
• Taylor Keymont
• Laura Khawaja, PA
• Kidney Care of Bonita Springs LLC
• Kidz Medical Services
• Kind Minds Ba Corp
• Kinexis LLC
• Kinexis LLC
• Denise Ingalls King, PT, DPT

• Pediatrics Physician in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.