Kattya Antenor, M.D.
Individual provider Active NPI Pediatrics Physician · Winter Garden, FL
NPI 1730440249 · NPPES record last updated Nov 10, 2021
Key facts
- NPI
- 1730440249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- ME124691 (FL)
- Practice address
- 2200 Fowler Grove Blvd Ste 220
Winter Garden, FL 34787-5597 - Phone
- (407) 656-0042
- Fax
- (407) 656-0633
- NPI assigned
- May 31, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211115001278 | FL | Practitioner - Pediatric Medicine | 9234374315 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Pediatrics | Current |
Accepting new patients |
| Florida Hospital Medical Group Inc | Current |
Accepting new patients |
Locations
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
2200 Fowler Grove Blvd
Ste 200
Winter Garden, FL 34787
Phone (407) 271-3607
2200 Fowler Grove Blvd
Ste 220
Winter Garden, FL 34787
Phone (407) 646-0042
1573 W Fairbanks Ave
Ste 300
Winter Park, FL 32789
Phone (407) 303-6729
Interoperability endpoints
- kantenor227983@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME124691 | FL | Yes |
Addresses
Primary practice location
2200 Fowler Grove Blvd Ste 220
Winter Garden, FL 34787-5597
Mailing address
2200 Fowler Grove Blvd Ste 220
Winter Garden, FL 34787-5597
Phone (407) 656-0042
Other names
- Kattya Jules
Other providers in Winter Garden, FL
- Andrew C Gooch DMD PLLC
- Anesthesiologists of Greater Orlando Inc
- Kelley Dawn Angelidis
- Tiffany Tamse Anscher
- Kristine Anspach
- Susan Antico
- Breanna Nichole Aponte
- April Boykin, LCSW PA
- Jannah Arafa
- Yessenia Arce-Jackson
All providers in Winter Garden, FL · Pediatrics Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.