NPIMap

Organization Active NPI

Professional Pediatrics

  • Primary Care Clinic/Center
  • Clermont, FL
National Provider Identifier
1992378202
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PROFESSIONAL PEDIATRICS
Practice address
1050 US Highway 27 Ste 5
Clermont, FL 34714-7508
Phone
(352) 404-8944
NPI assigned
Jul 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Mohammad Afzal, MDNPI 1669411161
Title
Owner
Phone
(352) 394-3929

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1050 US Highway 27 Ste 5
Clermont, FL 34714-7508

Mailing address

1050 US Highway 27 Ste 5
Clermont, FL 34714-7508

Other identifiers 1

IdentifierTypeStateIssuer
004770701MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Professional Pediatrics2 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.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1992378202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 US HIGHWAY 27 STE 5",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347147508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 US HIGHWAY 27 STE 5",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347147508",
            "telephone_number": "352-404-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "AFZAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-394-3929",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004770701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.