NPIMap

Organization Active NPI

New Interlachen Pediatrics, P.a.

  • Pediatrics Physician
  • Maitland, FL
National Provider Identifier
1659380459
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NEW INTERLACHEN PEDIATRICS, P.A.
Practice address
846 Lake Howell Rd
Maitland, FL 32751-5222
Phone
(407) 767-2477
Fax
(407) 834-9822
NPI assigned
Aug 8, 2006
Last updated
Oct 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Authorized official

Name
Mr. Luis Salazar
Title
Practice Administrator
Phone
(407) 767-2477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

846 Lake Howell Rd
Maitland, FL 32751-5222

Mailing address

846 Lake Howell Rd
Maitland, FL 32751-5222
Phone (407) 767-2477

Other practice location 1

1000 W Broadway St Ste 100
Oviedo, FL 32765-9261
Phone (407) 767-2477

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
10D0274424Interlachen Pediatrics PA1000 W Broadway Ste 100, Oviedo, FL 32765AccreditationJun 23, 2028
10D0665754Interlachen Pediatrics846 Lake Howell Rd, Maitland, FL 32751AccreditationJun 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
New Interlachen Pediatrics2 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.

Locations

846 Lake Howell Rd
Maitland, FL 32751
Phone (407) 571-5017

1000 W Broadway St
Ste 100
Oviedo, FL 32765
Phone (407) 767-2477

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539043200000",
    "number": "1659380459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 LAKE HOWELL RD",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515222",
            "telephone_number": "407-767-2477",
            "fax_number": "407-834-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 LAKE HOWELL RD",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515222",
            "telephone_number": "407-767-2477",
            "fax_number": "407-834-9822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Broadway St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327659261",
            "country_code": "US",
            "telephone_number": "407-767-2477",
            "fax_number": "407-767-1627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW INTERLACHEN PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-10-09",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "407-767-2477",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.