Ricardo Urdaneta Pereda, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME107169 Issued in FL

Practice address

4972 Town Center Pkwy Ste 301
Jacksonville, FL 32246

Phone

(904) 642-6100

Fax

(904) 642-5154

NPI assigned

May 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saltzman, Tanis, Pittell, Levin and Jacobson

  dba Pediatric Associates

  • Pediatrics Physician
  • Hollywood, FL
  • NPI 1639138480
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1407174436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "904-642-6100",
            "fax_number": "904-642-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4972 TOWN CENTER PKWY STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32246",
            "telephone_number": "904-642-6100",
            "fax_number": "904-642-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URDANETA PEREDA",
        "first_name": "RICARDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-14",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME107169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002242600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ricardo.urdanetapereda@pedsassoc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4972 Town Center Pkwy Ste 301",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claudia Cristina Urban, DO
• Edward Stevens Urban, MD
• Ashley E Urbay, PA
• Jacquelyn Christine Urbay, MA, CCC-SLP
• Rebecca D Urbonas, MD
• Kyrsten Urff, DNP, FNP-BC
• Urgent Care America LLC
• Urgent Lab Services LLC
• Urgentium LLC
• Allanah Michelle Uribe

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.