NPIMap

Organization Active NPI

Personal Pediatric Care PLLC

  • Pediatrics Physician
  • Trinity, FL
National Provider Identifier
1578860078
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME58972 Issued in FL
Legal business name
PERSONAL PEDIATRIC CARE PLLC
Practice address
3012 Starkey Blvd
Trinity, FL 34655-2175
Phone
(727) 645-6941
Fax
(727) 494-7684
NPI assigned
Feb 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Authorized official

Name
Jay Michael Harvey, M.D.
Title
Physician
Phone
(727) 645-6941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME58972 FL Primary

Addresses

Primary practice location

3012 Starkey Blvd
Trinity, FL 34655-2175

Mailing address

3012 Starkey Blvd
Trinity, FL 34655-2175
Phone (727) 645-6941

Other identifiers 1

IdentifierTypeStateIssuer
054287300MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1578860078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 STARKEY BLVD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346552175",
            "telephone_number": "727-645-6941",
            "fax_number": "727-494-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 STARKEY BLVD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346552175",
            "telephone_number": "727-645-6941",
            "fax_number": "727-494-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL PEDIATRIC CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "727-645-6941",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME58972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054287300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.