Principal Pediatric Group LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME58278 Issued in FL

Legal business name

PRINCIPAL PEDIATRIC GROUP LLC

Practice address

5900 S John Young Pkwy
Orlando, FL 32839-3716

Phone

(407) 398-6470

Fax

(407) 894-6872

NPI assigned

Feb 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ayodeji B Otegbeye, MD

Title

President

Phone

(407) 894-8768

Specialties & licenses 1

Addresses

Locations

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": "1245621127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 N THORNTON AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034003",
            "telephone_number": "407-894-8768",
            "fax_number": "407-894-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S JOHN YOUNG PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328393716",
            "telephone_number": "407-398-6470",
            "fax_number": "407-894-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCIPAL PEDIATRIC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "OTEGBEYE",
        "authorized_official_first_name": "AYODEJI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-894-8768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME58278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Prince, PHARMD
• Lourdes Elena Prince, ARNP
• Thomas Roy Prince, M.D.
• Princeton Pediatrics, PA
• Princeton Professional Services
• Jonathan Raymond Printup
• Heather Priore
• Priority Home Health Care Services LLC
• David Priscal, MD
• Veronica-Jo Prisco, LCSW

• Pediatrics Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatrics Physician in Florida

• 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.