Organization Active NPI

Navarre Pediatrics PL

  • Pediatric Adolescent Medicine Physician
  • Navarre, FL
National Provider Identifier
1679509194
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Authorized official

Name
Heba Elgoweni, M.D.NPI 1003842121
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)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
591-68789OtherALBLUE CROSS BLUE SHIELD OF ALABAMA
268997900MedicaidFL
34960OtherFLBLUE CROSS BLUE SHIELD OF FLORIDA

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
10D1022463Navarre Pediatrics PL8880 Navarre Pkwy Ste 102, Navarre, FL 32566Certificate of waiverMar 13, 2028

National Provider Directory

National Provider Directory

Locations

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.

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

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.

Verify at the official NPI Registry.