Kids Care Pediatrics of NW FL. Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KIDS CARE PEDIATRICS OF NW FL. INC

Practice address

4622 Summerdale Blvd
Pace, FL 32571

Phone

(850) 995-0169

Fax

(850) 995-2649

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer M Zimmerman, M.D.NPI 1134195613

Title

President

Phone

(850) 995-0169

Specialties & licenses 1

Addresses

Other identifiers 5

Tax ID family

Kids Care Pediatrics of NW FL Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kids Care Pediatrics of NW FL Inc

  • Pediatrics Physician
  • Navarre, FL
  • NPI 1528101557
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Mijares Zimmerman, M.D.

  • Pediatrics Physician
  • Pace, FL
  • NPI 1134195613
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912096033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 SUMMERDALE BLVD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "850-995-0169",
            "fax_number": "850-995-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 SUMMERDALE BLVD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "850-995-0169",
            "fax_number": "850-995-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS CARE PEDIATRICS OF NW FL. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-995-0169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST NETWORK",
            "identifier": "0540",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "32936",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "H8285",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "590 96036",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7960252",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zaher Kalaji, MD
• Kristin Kelly, D.C.
• Renee Alison Mae Kenton
• Jarod Keremes, BCABA
• Tuan Quoc Khuu, PHARMD
• Kids Talk Place LLC
• Robert Gerald Kincaid III, D.O.
• Janelle Suri King, M.S., CCC-SLP
• Matthew G. Kinzelman, MD
• Kristin Ashly Knoth

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.