NPIMap

Organization Active NPI

Florida Pediatric Associates, LLC

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1447553805
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FLORIDA PEDIATRIC ASSOCIATES, LLC
Practice address
1781 Park Center Dr
Suite 220
Orlando, FL 32835-6254
Phone
(407) 398-7730
Fax
(407) 398-7740
NPI assigned
Dec 7, 2010
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Sheila A Tatham
Title
Credentialing Manager
Phone
(727) 456-4250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1781 Park Center Dr
Suite 220
Orlando, FL 32835-6254

Mailing address

1800 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-4222
Phone (727) 456-3288

Other names 1

  • Florida Pediatric Assoc Optical Orlando Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110104000539 FL DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 2567375561 Practice locations: Orlando, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Florida Pediatric Associates LLC2 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

8530 Granite Ct
Fort Myers, FL 33908
Phone (239) 415-1131

10475 Centurion Pkwy N
Ste 302
Jacksonville, FL 32256
Phone (904) 398-5437

245 Riverside Ave
Ste 550
Jacksonville, FL 32202
Phone (904) 425-5075

6735 Conroy Rd
Ste 414
Orlando, FL 32835
Phone (407) 588-0550

3030 6th St S
St Petersburg, FL 33705
Phone (727) 894-8719

2508 W Virginia Ave
Ste B
Tampa, FL 33607
Phone (813) 878-2191

3001 W Mlk Blvd
Fl 3
Tampa, FL 33607
Phone (813) 870-4933

3248 Cove Bend Dr
Tampa, FL 33613
Phone (813) 972-1087

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1447553805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044222",
            "telephone_number": "727-456-3288",
            "fax_number": "727-456-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 PARK CENTER DR",
            "address_2": "SUITE 220",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356254",
            "telephone_number": "407-398-7730",
            "fax_number": "407-398-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PEDIATRIC ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-07",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "TATHAM",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "727-456-4250"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Pediatric Assoc Optical Orlando",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.