Peter Pan Day Care Center

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

PETER PAN DAY CARE CENTER

Practice address

1602 Bruton Blvd
Orlando, FL 32805-4230

Phone

(407) 293-3492

Fax

(407) 293-3492

NPI assigned

Jun 6, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Lucious Clarence Conway Jr.

Title

Director of Development

Phone

(407) 293-3492

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1720247448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 BRUTON BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328054230",
            "telephone_number": "407-293-3492",
            "fax_number": "407-293-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 BRUTON BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328054230",
            "telephone_number": "407-293-3492",
            "fax_number": "407-293-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER PAN DAY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "LUCIOUS",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "DIRECTOR OF DEVELOPMENT",
        "authorized_official_telephone_number": "407-293-3492",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Orlando, FL
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• Early Intervention Provider Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.