Active NPI
Florencio Antolin Nadal Jr., M.D.
- Pediatrics Physician
- Brandon, FL
National Provider Identifier
1992776025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME30766
- Practice address
- 621 Victoria St
Brandon, FL 33510-4313 - Phone
- (813) 655-0292
- Fax
- (813) 655-4302
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME30766 | FL | Primary |
Addresses
Primary practice location
621 Victoria St
Brandon, FL 33510-4313
Mailing address
PO Box 2715
Brandon, FL 33509-2715
Phone (813) 655-0292
Other practice location 1
376 E Bloomingdale Ave
Brandon, FL 33511-8155
Phone (813) 681-7101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061330400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME30766 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nadal Pediatrics, LLC | Pediatrics | Current | Accepting new patients |
| De Brigard Pediatrics, P.a | Past | Accepting new patients |
Locations
376 E Bloomingdale Ave
Brandon, FL 33511
Phone (813) 681-7101
621 Victoria St
Brandon, FL 33510
Phone (813) 655-0292
Interoperability endpoints
- drnadal@nadalpeds.opdirect.net
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Brandon, FL
- NPI 1013988146
-
- Primary Care Clinic/Center
- Brandon, FL
- NPI 1407248792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1992776025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2715",
"city": "BRANDON",
"state": "FL",
"postal_code": "335092715",
"telephone_number": "813-655-0292",
"fax_number": "813-655-4302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 VICTORIA ST",
"city": "BRANDON",
"state": "FL",
"postal_code": "335104313",
"telephone_number": "813-655-0292",
"fax_number": "813-655-4302"
}
],
"practiceLocations": [
{
"address_1": "376 E Bloomingdale Ave",
"address_purpose": "LOCATION",
"city": "Brandon",
"state": "FL",
"postal_code": "335118155",
"country_code": "US",
"telephone_number": "813-681-7101",
"fax_number": "813-571-7158",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NADAL",
"first_name": "FLORENCIO",
"middle_name": "ANTOLIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME30766",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061330400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.