Organization Active NPI

Plantation Pediatrics PA

  • Pediatrics Physician
  • Plantation, FL
National Provider Identifier
1417033077
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PLANTATION PEDIATRICS PA
Practice address
817 S University Dr
Ste 101
Plantation, FL 33324
Phone
(954) 474-5437
Fax
(954) 472-3783
NPI assigned
Oct 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carmen Virginia Sanchez
Title
Office Manager
Phone
(954) 431-0131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

817 S University Dr
Ste 101
Plantation, FL 33324

Mailing address

1851 NW 125TH Ave
Suite #150
Pembroke Pines, FL 33028-2597
Phone (954) 431-0131

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
10D0691757Plantation Pediatrics PA - Plantation Office817 S University Drive #101, Plantation, FL 33324Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Plantation Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1851 NW 125th Ave
Ste 150
Pembroke Pines, FL 33028

817 S University Dr
Ste 101
Plantation, FL 33324
Phone (954) 474-2500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11881/brand/1/csg/1/fhir/r4

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": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417033077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 NW 125TH AVE",
            "address_2": "SUITE #150",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282597",
            "telephone_number": "954-431-0131",
            "fax_number": "954-431-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 S UNIVERSITY DR",
            "address_2": "STE 101",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33324",
            "telephone_number": "954-474-5437",
            "fax_number": "954-472-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANTATION PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "VIRGINIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-431-0131"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.