Active NPI
Navarre Pediatrics PL
- Pediatric Adolescent Medicine Physician
- Navarre, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- Legal business name
- NAVARRE PEDIATRICS PL
- Practice address
- 8880 Navarre Pkwy Ste 102
Navarre, FL 32566-3613 - Phone
- (850) 939-5550
- Fax
- (850) 939-5445
- NPI assigned
- Jun 25, 2006
- Last updated
- May 8, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Heba Elgoweni, M.D.
- Title
- Provider
- Phone
- (850) 939-5550
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | Primary |
Addresses
Primary practice location
8880 Navarre Pkwy Ste 102
Navarre, FL 32566-3613
Mailing address
8880 Navarre Pkwy Ste 102
Navarre, FL 32566-3613
Phone (850) 939-5550
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 591-68789 | Other | AL | BLUE CROSS BLUE SHIELD OF ALABAMA |
| 268997900 | Medicaid | FL | |
| 34960 | Other | FL | BLUE CROSS BLUE SHIELD OF FLORIDA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1022463 | Navarre Pediatrics PL | Certificate of waiver | Mar 13, 2028 |
National Provider Directory
National Provider DirectoryLocations
8750 Ortega Park Dr
Navarre, FL 32566
Phone (850) 710-3306
8880 Navarre Pkwy
Ste 102
Navarre, FL 32566
Phone (850) 939-5550
Practitioners & affiliated clinicians
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.
-
- Pediatric Adolescent Medicine Physician
- Navarre, FL
- NPI 1003842121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210204800000",
"number": "1679509194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8880 NAVARRE PKWY STE 102",
"city": "NAVARRE",
"state": "FL",
"postal_code": "325663613",
"telephone_number": "850-939-5550",
"fax_number": "850-939-5445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8880 NAVARRE PKWY STE 102",
"city": "NAVARRE",
"state": "FL",
"postal_code": "325663613",
"telephone_number": "850-939-5550",
"fax_number": "850-939-5445"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NAVARRE PEDIATRICS PL",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-25",
"last_updated": "2008-05-08",
"status": "A",
"authorized_official_last_name": "ELGOWENI",
"authorized_official_first_name": "HEBA",
"authorized_official_title_or_position": "PROVIDER",
"authorized_official_telephone_number": "850-939-5550",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics, Adolescent Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
"identifier": "591-68789",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "268997900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
"identifier": "34960",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Navarre, FL
- Navarre Family Health PA
- Navarre Gardens, LLC
- Navarre Gardens, LLC
- Navarre Healing Arts, LLC
- Navarre Medical Associates (Internal Medicine and Pediatrics of Navarre)
- Navarre Primary Care LLC
- Navarre Sleep Disorder Group Inc
- Navarre Terrezza Optical Group OD PA
- Navarre Urgent Care, LLC (Navarre Urgent Care)
- Kristina M Nelon, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.