NPIMap

Organization Active NPI

Children'S Specialist Pediatric Pulmonology of Florida LLC

  • Specialist
  • Fort Myers, FL
National Provider Identifier
1497944193
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0091014 Issued in FL
Legal business name
CHILDREN'S SPECIALIST PEDIATRIC PULMONOLOGY OF FLORIDA LLC
Practice address
12748 University Dr
Fort Myers, FL 33907-5634
Phone
(239) 464-8089
Fax
(239) 437-5507
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Mrs. Kathleen Wegelin
Title
Office Administrator
Phone
(239) 437-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X ME0091014 FL Primary

Addresses

Primary practice location

12748 University Dr
Fort Myers, FL 33907-5634

Mailing address

12748 University Dr
Fort Myers, FL 33907-5634
Phone (239) 437-5500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address oscaralea@csppfl.allscriptsdirect.net

National Provider Directory

National Provider Directory

Locations

12748 University Dr
Fort Myers, FL 33907
Phone (239) 437-5500

7970 Summerlin Lakes Dr
Ste 200
Fort Myers, FL 33907
Phone (239) 936-2020

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1497944193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12748 UNIVERSITY DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075634",
            "telephone_number": "239-437-5500",
            "fax_number": "239-437-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12748 UNIVERSITY DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075634",
            "telephone_number": "239-464-8089",
            "fax_number": "239-437-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S SPECIALIST PEDIATRIC PULMONOLOGY OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "WEGELIN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "239-437-5500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0091014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oscaralea@csppfl.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "12748 University Dr",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339075634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.