NPIMap

Organization Active NPI

Kidz Pediatric Multispecialty

  • Pediatric Otolaryngology Physician
  • Fort Myers, FL
National Provider Identifier
1417494873
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
OS 10324 Issued in FL
Legal business name
KIDZ PEDIATRIC MULTISPECIALTY
Practice address
14421 Metropolis Ave
Suite 103
Fort Myers, FL 33912-4323
Phone
(239) 597-7000
Fax
(239) 552-4060
NPI assigned
Jan 24, 2017
Last updated
Jan 24, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
KIDZ MEDICAL SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Authorized official

Name
Irene Navarro
Title
Credentialing Specialist
Phone
(305) 661-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X OS 10324 FL Primary

Addresses

Primary practice location

14421 Metropolis Ave
Suite 103
Fort Myers, FL 33912-4323

Mailing address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515

National Provider Directory

National Provider Directory
Tax ID family
Kidz Medical Services16 organizations share this tax ID, including this one
Part of
Kidz Medical Services

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1417494873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515",
            "fax_number": "305-663-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14421 METROPOLIS AVE",
            "address_2": "SUITE 103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124323",
            "telephone_number": "239-597-7000",
            "fax_number": "239-552-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ PEDIATRIC MULTISPECIALTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIDZ MEDICAL SERVICES, INC",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "305-661-1515"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "OS 10324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.