NPIMap

Organization Active NPI

Kidz Medical Services

  • Pediatric Cardiology Physician
  • Port St Lucie, FL
National Provider Identifier
1235604307
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
KIDZ MEDICAL SERVICES
Practice address
10521 SW Village Center Dr Ste 101
Port St Lucie, FL 34987-1930
Phone
(561) 558-1212
Fax
(833) 464-4219
NPI assigned
Oct 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Irene Navarro
Title
Credentialing Specialist
Phone
(305) 662-3290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

10521 SW Village Center Dr Ste 101
Port St Lucie, FL 34987-1930

Mailing address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515

Other identifiers 1

IdentifierTypeStateIssuer
257829800MedicaidFL

Other names 1

  • Pt St. Lucie Other name

National Provider Directory

National Provider Directory
Tax ID family
Kidz Pediatric Multispecialty16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1235604307",
    "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": "10521 SW VILLAGE CENTER DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349871930",
            "telephone_number": "561-558-1212",
            "fax_number": "833-464-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "305-662-3290"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257829800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pt St. Lucie",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pt St. Lucie",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.