Active NPI
Sunshine Pediatrics of Brevard
- Pediatric Adolescent Medicine Physician
- Melbourne, FL
National Provider Identifier
1487731931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- ME59415
- 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
- Last updated
- Jan 4, 2013
- Organization subpart
- No
NPPES NPI Registry
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
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | ME59415 | FL | Primary |
Addresses
Primary practice location
445 Pineda CT
Melbourne, FL 32940-7555
Mailing address
445 Pineda CT
Melbourne, FL 32940-7555
Phone (321) 254-8400
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Pediatric Adolescent Medicine Physician
- Melbourne, FL
- NPI 1780785121
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
- Sunmed Health Group Inc
- Sunnyskies Support Service (Veronica C Hodges)
- 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 (Wuesthoff X-ray and Lab at Baytree)
Sources for this page
- 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.