Southeastern Pediatric & Adolescent Medicine, S.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE, S.C.

Doing business as

Southeastern Pediatric & Adolescent Medicine

Practice address

8532 W Capitol Dr
Milwaukee, WI 53222-1848

Phone

(414) 463-2607

Fax

(414) 463-6743

NPI assigned

Mar 12, 2007

Last updated

Apr 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rosie Deltoro

Title

Assistant Office Manager

Phone

(414) 463-2607

Specialties & licenses 1

Addresses

Other names 1

• Southeastern Pediatric & Adolescent Medicine Doing business as

Tax ID family

Noemi a Prieto MD SC2 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.

• Noemi a Prieto MD SC

  dba Southeastern Pediatric & Adolescent Medicine

  • Primary Care Clinic/Center
  • Milwaukee, WI
  • NPI 1447365614
  NPD tax ID

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1457483612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8532 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221848",
            "telephone_number": "414-463-2607",
            "fax_number": "414-463-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8532 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221848",
            "telephone_number": "414-463-2607",
            "fax_number": "414-463-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "DELTORO",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "414-463-2607"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Pediatric & Adolescent Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Center Medical Group LTD
• South Side Guadalupe Dental Clinic Inc
• James South, LPC-IT, M.S., PH.D.
• Southeast Surgical, S.C.
• Southeastern Family Practice SC
• Southern Home Health
• Southern Lakes Physical Therapy
• James F Southern, MD
• Southside Pediatrics Assoc
• Southside Primary Care

• Pediatrics Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.