Children's Express Care Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

604727 Issued in FL

Legal business name

CHILDREN'S EXPRESS CARE CLINIC

Practice address

430 College Dr Unit 100-102
Middleburg, FL 32068-8530

Phone

(904) 644-8669

NPI assigned

Jan 5, 2012

Last updated

Jul 21, 2022By 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

Dr. Suwarna M Tilak, MDNPI 1174546584

Title

President

Phone

(904) 519-0008

Specialties & licenses 1

Addresses

Tax ID family

Children's Express Care Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Children's Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1114424280
  NPD tax ID
• Children's Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • Saint Johns, FL
  • NPI 1538735246
  NPD tax ID
• Children's Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • Middleburg, FL
  • NPI 1730685157
  NPD tax ID

Locations

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Children's Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1114424280
  NPPES parent name
• Children's Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • Saint Johns, FL
  • NPI 1538735246
  NPPES parent name
• Children's Express Care Clinic

  dba Excel Pediatrics

  • Pediatrics Physician
  • Middleburg, FL
  • NPI 1730685157
  NPPES parent name

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.

• Suwarna M Tilak, MD

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1174546584
  Authorized official Same address or phone

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1548530736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566750",
            "telephone_number": "904-519-0008",
            "fax_number": "904-379-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 COLLEGE DR UNIT 100-102",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688530",
            "telephone_number": "904-644-8669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Durbin Station Ct Unit 503",
            "address_purpose": "LOCATION",
            "city": "St Johns",
            "state": "FL",
            "postal_code": "322599370",
            "country_code": "US",
            "telephone_number": "904-519-0008",
            "fax_number": "904-379-7312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10175 Fortune Pkwy Unit 402",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32256",
            "country_code": "US",
            "telephone_number": "904-519-0008",
            "fax_number": "904-379-7312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHILDREN'S EXPRESS CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "TILAK",
        "authorized_official_first_name": "SUWARNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-519-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "604727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pauline Celestial, PHARMD
• Cep America LLC
• Jill Ceragioli, LMHC
• Chas Group
• Child Guidance Center, Inc.
• Children's Express Care Clinic (Excel Pediatrics)
• Brandon Chin, DMD
• Tiera Chisolm
• Leon C Chow, MD
• Jo Cisco, LMHC

• Pediatrics Physician in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.