NPIMap

Organization Active NPI

Nemours Children's Health, Waterford Lakes, Specialty Care

  • Multi-Specialty Clinic/Center
  • Orlando, FL
National Provider Identifier
1205404761
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NEMOURS CHILDREN'S HEALTH, WATERFORD LAKES, SPECIALTY CARE
Doing business as
Nemours Children's Health, Waterford Lakes, Specialty Care
Practice address
651 N Alafaya TRL
Orlando, FL 32828-7045
Phone
(407) 650-7715
NPI assigned
Jun 11, 2021
Last updated
Jun 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
THE NEMOURS FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
Rodney Aaron McKendree
Title
VP, Finance
Phone
(904) 697-5648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

651 N Alafaya TRL
Orlando, FL 32828-7045

Mailing address

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532

Other names 1

  • Nemours Children's Health, Waterford Lakes, Specialty Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nemours Children's Health Fort Walton Beach Specialty Care75 organizations share this tax ID, including this one
Part of
Nemours Children's Health Fort Walton Beach Specialty Care

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1205404761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 N ALAFAYA TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287045",
            "telephone_number": "407-650-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEMOURS CHILDREN'S HEALTH, WATERFORD LAKES, SPECIALTY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE NEMOURS FOUNDATION",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "MCKENDREE",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "904-697-5648"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nemours Children's Health, Waterford Lakes, Specialty Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.