NPIMap

Organization Active NPI

Excel Pediatrics

  • Rural Health Clinic/Center
  • Tavares, FL
National Provider Identifier
1386966968
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
ME72542 Issued in FL
Legal business name
EXCEL PEDIATRICS
Practice address
2523 Dora Ave
Tavares, FL 32778-4977
Phone
(352) 394-3929
NPI assigned
Feb 23, 2010
Last updated
Nov 2, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
EXCEL PEDIATRICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Authorized official

Name
Dr. Mohammad Afzal, MDNPI 1669411161
Title
President
Phone
(352) 394-3929

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME72542 FL
Rural Health Clinic/Center 261QR1300X ME72542 FL Primary

Addresses

Primary practice location

2523 Dora Ave
Tavares, FL 32778-4977

Mailing address

2523 Dora Ave
Tavares, FL 32778-4977
Phone (352) 394-3929

Other identifiers 3

IdentifierTypeStateIssuer
K2959OtherFLMEDICARE
260332200MedicaidFL
004771000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Excel Pediatrics PA3 organizations share this tax ID, including this one
Part of
Excel Pediatrics PA

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1386966968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 DORA AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784977",
            "telephone_number": "352-394-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 DORA AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784977",
            "telephone_number": "352-394-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCEL PEDIATRICS",
        "enumeration_date": "2010-02-23",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "AFZAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-394-3929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME72542",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "FL",
            "license": "ME72542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K2959",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260332200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004771000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.