Active NPI
Pediatric Health Choice
- Clinic/Center
- St Petersburg, FL
National Provider Identifier
1487051306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- PEDIATRIC HEALTH CHOICE
- Practice address
- 3110 75TH St N
St Petersburg, FL 33710-2326 - Phone
- (727) 347-0010
- NPI assigned
- Nov 20, 2014
- Organization subpart
- Yes
- Parent organization
- PRESCRIBED PEDIATRIC EXTENDED CARE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Deborah Fraze
- Title
- Executive VP
- Phone
- (813) 880-0320
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
3110 75TH St N
St Petersburg, FL 33710-2326
Mailing address
8509 Benjamin Rd
Suite D
Tampa, FL 33634-1224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 882377400 | Medicaid | FL |
National Provider Directory
National Provider Directory- Tax ID family
- Pediatric Health Choice
- Part of
- Pediatric Health Choice
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Medically Fragile Infants and Children Day Care
- St Petersburg, FL
- NPI 1023468162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648425600000",
"number": "1487051306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8509 BENJAMIN RD",
"address_2": "SUITE D",
"city": "TAMPA",
"state": "FL",
"postal_code": "336341224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3110 75TH ST N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337102326",
"telephone_number": "727-347-0010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC HEALTH CHOICE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PRESCRIBED PEDIATRIC EXTENDED CARE",
"enumeration_date": "2014-11-20",
"last_updated": "2022-03-28",
"certification_date": "2022-03-28",
"status": "A",
"authorized_official_last_name": "FRAZE",
"authorized_official_first_name": "DEBORAH",
"authorized_official_title_or_position": "EXECUTIVE VP",
"authorized_official_telephone_number": "813-880-0320"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "882377400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
- Pediatric Feeding and Swallowing Associates
- Pediatric Feeding and Swallowing Associates
- Pediatric Gastroenterology Hepatology & Nutrition of FL P a
- Pediatric Health Care Alliance, PA
- Pediatric Health Choice
- Pediatric Hematology/Oncology ASC PA
- Pediatric Neurology Associates
- Pediatric Otolaryngology Head and Neck Surgeyr Assoc. PA
- Pediatric Physician Services, Inc.
- Pediatric Surgical Group, P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.