Organization Active NPI

407 Pediatrics LLC

  • Pediatrics Physician
  • Davenport, FL
National Provider Identifier
1184504102
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
407 PEDIATRICS LLC
Practice address
161 Webb Dr Ste 300
Davenport, FL 33837-3965
Phone
(407) 873-5979
NPI assigned
Sep 3, 2025
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Danielle Hernandez, MDNPI 1972900132
Title
Registered Agent/Owner
Phone
(407) 873-5979

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

161 Webb Dr Ste 300
Davenport, FL 33837-3965

Mailing address

161 Webb Dr Ste 300
Davenport, FL 33837-3965
Phone (407) 873-5979

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2331582407 Pediatrics LLC161 Webb Dr, Ste 300, Davenport, FL 33837Certificate of waiverOct 5, 2027

National Provider Directory

National Provider Directory

Locations

161 Webb Dr
Ste 300
Davenport, FL 33837
Phone (407) 873-5979

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1184504102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WEBB DR STE 300",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338373965",
            "telephone_number": "407-873-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 WEBB DR STE 300",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338373965",
            "telephone_number": "407-873-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "407 PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "REGISTERED AGENT/OWNER",
        "authorized_official_telephone_number": "407-873-5979",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.