NPIMap

Organization Active NPI

Pediatric Health Care Alliance, PA

  • Pediatrics Physician
  • Oldsmar, FL
National Provider Identifier
1609965441
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC HEALTH CARE ALLIANCE, PA
Practice address
720 Brooker Creek Blvd Ste 215
Oldsmar, FL 34677-2937
Phone
(813) 854-2003
Fax
(813) 436-5378
NPI assigned
Oct 12, 2006
Last updated
Jan 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Debra S. Gonzalez
Title
Chief Administrative Officer
Phone
(813) 854-2003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

720 Brooker Creek Blvd Ste 215
Oldsmar, FL 34677-2937

Mailing address

720 Brooker Creek Blvd Ste 215
Oldsmar, FL 34677-2937
Phone (813) 854-2003

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Health Care Alliance PA15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

225 Harbor Village Ln
Apollo Beach, FL 33572
Phone (813) 493-1779

811 S Parsons Ave
Brandon, FL 33511
Phone (813) 471-9709

12951 Walsingham Rd
Largo, FL 33774
Phone (727) 391-0158

14713 Sully Run
Odessa, FL 33556
Phone (813) 475-7100

10729 Queens Town Dr
Riverview, FL 33579
Phone (813) 672-3497

3222 W Azeele St
Tampa, FL 33609
Phone (813) 872-8491

3638 Madaca Ln
Tampa, FL 33618
Phone (813) 968-6610

4911 S Manhattan Ave
Tampa, FL 33611
Phone (813) 755-4025

5259 Village Market
Wesley Chapel, FL 33544
Phone (813) 973-0333

Practitioners & affiliated clinicians

Practitioners 106

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.

View all 106

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1609965441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 BROOKER CREEK BLVD STE 215",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346772937",
            "telephone_number": "813-854-2003",
            "fax_number": "813-436-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 BROOKER CREEK BLVD STE 215",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346772937",
            "telephone_number": "813-854-2003",
            "fax_number": "813-436-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTH CARE ALLIANCE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "813-854-2003"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oldsmar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.