Organization Active NPI

Pediatric Care Center Inc

  • Pediatrics Physician
  • Palm Springs, FL
National Provider Identifier
1396095998
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC CARE CENTER INC
Practice address
2135 S Congress Ave Ste 2C
Palm Springs, FL 33406-7611
Phone
(561) 432-1822
Fax
(561) 432-0108
NPI assigned
Sep 12, 2012
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Armando Gonzalez, M.D.
Title
Owner/Ao
Phone
(561) 432-1822

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME0063404 FL
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

2135 S Congress Ave Ste 2C
Palm Springs, FL 33406-7611

Mailing address

2135 S Congress Ave Ste 2C
Palm Springs, FL 33406-7611
Phone (561) 432-1822

Other identifiers 3

IdentifierTypeStateIssuer
114618000MedicaidFL
003999000MedicaidFL
379462800MedicaidFL

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
10D1065877Pediatric Care Center No 2 Inc2135 S Congress Ave BLDG 2 Ste a-B, Palm Springs, FL 33406Certificate of waiverMar 11, 2027

National Provider Directory

National Provider Directory

Locations

2135 S Congress Ave
Ste 2C
Palm Springs, FL 33406
Phone (561) 432-1822

2135 S Congress Ave
Ste 2CD
Palm Springs, FL 33406
Phone (561) 432-1822

Practitioners & affiliated clinicians

Practitioners 1

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": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1396095998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 S CONGRESS AVE STE 2C",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334067611",
            "telephone_number": "561-432-1822",
            "fax_number": "561-432-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 S CONGRESS AVE STE 2C",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334067611",
            "telephone_number": "561-432-1822",
            "fax_number": "561-432-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_title_or_position": "OWNER/AO",
        "authorized_official_telephone_number": "561-432-1822",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0063404",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114618000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003999000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379462800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.