Active NPI
Safari Pediatrics, PA
- Pediatrics Physician
- Winter Park, FL
National Provider Identifier
1952782559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME110851
- Legal business name
- SAFARI PEDIATRICS, PA
- Practice address
- 340 N Wymore Rd
Suite B
Winter Park, FL 32789-2823 - Phone
- (407) 613-2473
- Fax
- (407) 613-2474
- NPI assigned
- Jun 9, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Fatan Jaafar, MD
- Title
- President
- Phone
- (734) 476-8989
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME110851 | FL | Primary |
Addresses
Primary practice location
340 N Wymore Rd
Suite B
Winter Park, FL 32789-2823
Mailing address
PO Box 490
Winter Park, FL 32790-0490
Phone (407) 613-2473
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME | Other | FL | ME110851 |
| 005523100 | Medicaid | FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2098833 | Safari Pediatrics PA | Certificate of waiver | Jul 14, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433808000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1433808000000",
"number": "1952782559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 490",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327900490",
"telephone_number": "407-613-2473",
"fax_number": "407-613-2474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 N WYMORE RD",
"address_2": "SUITE B",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327892823",
"telephone_number": "407-613-2473",
"fax_number": "407-613-2474"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFARI PEDIATRICS, PA",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-09",
"last_updated": "2015-06-09",
"status": "A",
"authorized_official_last_name": "JAAFAR",
"authorized_official_first_name": "FATAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "734-476-8989",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "FL",
"license": "ME110851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME110851",
"identifier": "ME",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005523100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.