NPIMap

Organization Active NPI

Professional Park Pediatrics P.a.

  • Pediatrics Physician
  • Tallahassee, FL
National Provider Identifier
1841289204
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME82183 Issued in FL
Legal business name
PROFESSIONAL PARK PEDIATRICS P.A.
Practice address
1881 Wellness Way Ste 80
Tallahassee, FL 32308-5976
Phone
(850) 402-5454
Fax
(850) 402-5451
NPI assigned
Oct 18, 2005
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Dr. Walter G. Bunnell III, M.D.NPI 1467441675
Title
President
Phone
(850) 402-5454

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME37597 FL
Pediatrics Physician 208000000X ME75773 FL
Pediatrics Physician 208000000X ME82183 FL Primary
Pediatrics Physician 208000000X ME91797 FL

Addresses

Primary practice location

1881 Wellness Way Ste 80
Tallahassee, FL 32308-5976

Mailing address

1881 Wellness Way Ste 80
Tallahassee, FL 32308-5976
Phone (850) 402-5454

National Provider Directory

National Provider Directory

Locations

1881 Professional Park Cir
#80
Tallahassee, FL 32308
Phone (850) 402-5454

1881 Wellness Way
#80
Tallahassee, FL 32308

Practitioners & affiliated clinicians

Practitioners 12

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": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1841289204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 WELLNESS WAY STE 80",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085976",
            "telephone_number": "850-402-5454",
            "fax_number": "850-402-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 WELLNESS WAY STE 80",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085976",
            "telephone_number": "850-402-5454",
            "fax_number": "850-402-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PARK PEDIATRICS P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "BUNNELL",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-402-5454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME37597",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME75773",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME82183",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME91797",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.