Sunshine Pediatrics of Brevard

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

ME59415 Issued in FL

Legal business name

SUNSHINE PEDIATRICS OF BREVARD

Practice address

445 Pineda CT
Melbourne, FL 32940-7555

Phone

(321) 254-8400

Fax

(321) 254-7306

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Yolanda Mantecon Mateos, MD

Title

Physician

Phone

(321) 254-8400

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1487731931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 PINEDA CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407555",
            "telephone_number": "321-254-8400",
            "fax_number": "321-254-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 PINEDA CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407555",
            "telephone_number": "321-254-8400",
            "fax_number": "321-254-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE PEDIATRICS OF BREVARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "MATEOS",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_middle_name": "MANTECON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "321-254-8400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME59415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058416900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058052000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunmed Health Group Inc
• Sunnyskies Support Service
• Sunrise Care & Consulting, LLC
• Sunrise Psychology LLC
• Ashlyn Sunseri, PA-C
• Sunshine Smiles
• Sunshine Telemedicine, Inc.
• William R Sunter Jr., MD
• Suntree Behavior Analysis, LLC
• Suntree Diagnostic Center

• Pediatric Adolescent Medicine Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Pediatric Adolescent Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.