Tavares Pediatrics Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

TAVARES PEDIATRICS INC

Practice address

2754 Dora Ave
Tavares, FL 32778-4970

Phone

(352) 508-5176

NPI assigned

Jul 23, 2021

Last updated

Dec 13, 2023By 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

Mohammad Afzal, MDNPI 1669411161

Title

Owner

Phone

(352) 394-3929

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Tavares Pediatrics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Tavares Pediatrics Inc

  • Rural Health Clinic/Center
  • Tavares, FL
  • NPI 1679854343
  NPD tax ID

Locations

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.

• Mohammad Afzal, MD MBA

  • Pediatrics Physician
  • Clermont, FL
  • NPI 1669411161
  Authorized official Same address or phone

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1629641923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2754 DORA AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2754 DORA AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784970",
            "telephone_number": "352-508-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVARES PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "AFZAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-394-3929",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004771001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eva Takacs-Dilorenzo, MD
• Takita S. Hayes
• Takita S. Hayes Dba Takita's Helping Hands
• Tara M. Kapinos, NCC, LMHC
• Tavares Dental PLLC
• Tavares Pediatrics Inc
• Tavares Pharmacy LLC (Tavares Pharmacy)
• Tavares Pharmacy LLC
• Tavares Surgery LLC
• Tavares Village Retirement Community, LLC (The Cove at Tavares Village)

• Primary Care Clinic/Center in Tavares, FL
• Providers in Tavares, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.