Organization Active NPI

All4Kidz Pediatrics, LLC

Doing business as ALL4KIDZ Pediatrics

  • Pediatrics Physician
  • St Petersburg, FL
National Provider Identifier
1568071165
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ALL4KIDZ PEDIATRICS, LLC
Doing business as
ALL4KIDZ Pediatrics
Practice address
1907 Tyrone Blvd N
St Petersburg, FL 33710-4841
Phone
(727) 317-2117
Fax
(727) 317-2104
NPI assigned
Jul 29, 2020
Last updated
Jul 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Salil G Jacob, MDNPI 1245256163
Title
Owner, Provider
Phone
(727) 317-2117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1907 Tyrone Blvd N
St Petersburg, FL 33710-4841

Mailing address

1907 Tyrone Blvd N
St Petersburg, FL 33710-4841
Phone (727) 317-2117

Other names 1

  • ALL4KIDZ Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2187753All4Kidz Pediatrics LLC1907 Tyrone Blvd, Saint Petersburg, FL 33710Certificate of waiverJul 6, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1568071165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-317-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-317-2117",
            "fax_number": "727-317-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL4KIDZ PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "SALIL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER, PROVIDER",
        "authorized_official_telephone_number": "727-317-2117",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALL4KIDZ Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.