Sonni's Pediatrics, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SONNI'S PEDIATRICS, INC.

Practice address

1125 S 6TH Ave
Wauchula, FL 33873-3350

Phone

(863) 767-1616

Fax

(863) 767-1619

NPI assigned

Jun 6, 2011

Last updated

Jan 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurence Thomas Hren

Title

Ceo

Phone

(863) 676-1770

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760776900. Details of each certification follow.

• CCN 103952 Rural health clinic · Active · Details

Rural health clinic certification: CCN 103952

Legal name

SONNIS PEDIATRICS INC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jun 27, 2012

Last certification

May 9, 2022

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

May 23, 2011 in FL

Enrollment address

1125 South Sixth Avenue
Wauchula, FL 33873-3350

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Avon Park Pediatrics, Inc.

  • Pediatrics Physician
  • Avon Park, FL
  • NPI 1811135502

  Central Florida Pediatric Associates Inc

  CMS ownership
• Heartland Pediatrics of Lake Placid, Inc.

  • Pediatrics Physician
  • Lake Placid, FL
  • NPI 1265453203

  Central Florida Pediatric Associates Inc

  CMS ownership
• Heartland Pediatrics of Lake Wales, LLC

  • Pediatrics Physician
  • Lake Wales, FL
  • NPI 1104989680

  Central Florida Pediatric Associates Inc

  CMS ownership

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1760776900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 S 6TH AVE",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733350",
            "telephone_number": "863-767-1616",
            "fax_number": "863-767-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S 6TH AVE",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733350",
            "telephone_number": "863-767-1616",
            "fax_number": "863-767-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONNI'S PEDIATRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "HREN",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-676-1770"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004416500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006449300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Wauchula, FL
• Providers in Wauchula, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.