Organization Active NPI

Total Pediatric Care

  • Pediatrics Physician
  • Fort Lauderdale, FL
National Provider Identifier
1316349905
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0060159 Issued in FL
Legal business name
TOTAL PEDIATRIC CARE
Doing business as
Total Pediatric Care
Practice address
100 E Commercial Blvd
Ft Lauderdale, FL 33334-1687
Phone
(954) 351-0202
Fax
(954) 351-0201
NPI assigned
Sep 25, 2014
Last updated
Sep 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Jeanetta Flood, MA
Title
Office Manager
Phone
(954) 351-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME0060159 FL Primary

Addresses

Primary practice location

100 E Commercial Blvd
Ft Lauderdale, FL 33334-1687

Mailing address

100 E Commercial Blvd
Ft Lauderdale, FL 33334-1687
Phone (954) 351-0202

Other identifiers 1

IdentifierTypeStateIssuer
370024101MedicaidFL

Other names 1

  • Total Pediatric Care Doing business as

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
10D0912207Total Pediatric Care100 E Commercial Blvd, Fort Lauderdale, FL 33334Certificate of waiverMar 6, 2027

National Provider Directory

National Provider Directory

Locations

100 E Commercial Blvd
Ft Lauderdale, FL 33334
Phone (954) 256-8966

Practitioners & affiliated clinicians

Practitioners 6

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": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1316349905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E COMMERCIAL BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333341687",
            "telephone_number": "954-351-0202",
            "fax_number": "954-351-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E COMMERCIAL BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333341687",
            "telephone_number": "954-351-0202",
            "fax_number": "954-351-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL PEDIATRIC CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "FLOOD",
        "authorized_official_first_name": "JEANETTA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-351-0202",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0060159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370024101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Total Pediatric Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.