NPIMap

Organization Active NPI

Pelican Pediatrics

  • Pediatrics Physician
  • Sebastian, FL
National Provider Identifier
1316287394
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME87138 Issued in FL
Legal business name
PELICAN PEDIATRICS
Practice address
13832 US Highway 1
Sebastian, FL 32958-3296
Phone
(772) 581-0636
NPI assigned
Feb 27, 2013
Last updated
Feb 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Dr. Kimberly GrazianoNPI 1205874393
Title
MD/Owner
Phone
(772) 581-0636

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 Physician 208000000X ME87138 FL Primary

Addresses

Primary practice location

13832 US Highway 1
Sebastian, FL 32958-3296

Mailing address

13832 US Highway 1
Sebastian, FL 32958-3296

Other identifiers 1

IdentifierTypeStateIssuer
271342000MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1361923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1316287394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13832 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13832 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583296",
            "telephone_number": "772-581-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "GRAZIANO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "772-581-0636",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME87138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271342000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.