TLC PEDIATRIC & ADOLESCENT MEDICINE, P.A. (NPI# 1629001425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629001425 |
| Entity Type | Organization |
| Organization Name | TLC PEDIATRIC & ADOLESCENT MEDICINE, P.A. |
| Practice Address |
1834 N Alafaya Trl Suite A Orlando FL 32826-4743 |
| Practice Telephone | 4073809115 |
| Practice Fax Number | 4073809189 |
| Mailing Telephone | 4073809115 |
| Mailing Fax Number | 4073809189 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBBIE REYNOLDS-LACY (OFFICE MANAGER) |
| Authorized Official Telephone | 4073809115 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 97689 | 01 |
| FL | K8880 | 05 |
| Street Address |
1834 N ALAFAYA TRL SUITE A |
| City | ORLANDO |
| State | FL |
| Zip Code | 32826-4743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801337738 | Sarah Matthews | Nurse Practitioner | 1834 N Alafaya Trl, Suite A, Orlando, FL 32826-4743 | 2017-03-11 |
| 1700273000 | Home Physicians Group P.a. | Family Medicine | 1834 N Alafaya Trl, Ste A, Orlando, FL 32826-4743 | 2015-04-24 |
| 1851791651 | Eugena Watson-johnson | Nurse Practitioner | 1834 N Alafaya Trl, Orlando, FL 32826-4743 | 2014-08-28 |
| 1114336740 | Physician Next Door, LLC | Family Medicine | 1834 N Alafaya Trl, Suite C, Orlando, FL 32826-4743 | 2014-08-07 |
| 1568716645 | Physician Next Door, LLC | Family Medicine | 1834 N Alafaya Trl, Ste C, Orlando, FL 32826-4743 | 2012-10-29 |
| 1114070570 | Juan Jose Gonzalez | Internal Medicine | 1834 N Alafaya Trl, Suite A, Orlando, FL 32826-4743 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851908859 | Deja Duclos | Student in an Organized Health Care Education/Training Program | 12201 Research Pakwy, Suite 300, Orlando, FL 32826 | 2020-09-24 |
| 1407330145 | Providence Dental LLC | Dentist | 12450 E. Colonial Drive Suite 124, Orlando, FL 32826 | 2018-09-19 |
| 1013404391 | Maria Elena Burgett | Massage Therapist | 1858 N Alafaya Trl Ste 209, Orlando, FL 32826 | 2018-04-22 |
| 1033646112 | Shayna Anne Ellery | Behavior Technician | 2100 N Alafaya Trl Ste 300, Orlando, FL 32826 | 2017-05-19 |
| 1003341769 | Samantha Justyn | Pharmacist | 12612 Challenger Parkway, Suite 365, Orlando, FL 32826 | 2017-05-01 |
| 1083152946 | Brenda Garcia | Counselor | 3157 N. Alafaya Trail, Orlando, FL 32826 | 2017-02-10 |
| 1588106017 | Christina Marie Calamis | Behavior Technician | 2100 N Alafaya Trl, Orlando, FL 32826 | 2016-11-15 |
| 1427406115 | Leslie Selina Bennett | Behavioral Analyst | 13645 E Colonial Dr Apt D390, Orlando, FL 32826 | 2016-06-02 |
| 1003219130 | Helen Waller | Social Worker | 12080 Mendel Dr, Orlando, FL 32826 | 2014-10-03 |
| 1992070783 | Erin Jean Pearce | Nurse Practitioner | 3151 North Alafaya Trail Suite 101, Orlando, FL 32826 | 2012-03-13 |
| Find all providers in zip 32826 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329355 | Brittani Newport | Pediatrics | 10743 Narcoossee Rd Ste A13, Orlando, FL 32832-6946 | 2020-02-24 |
| 1467091959 | Jennifer Dolcater Ketchersid | Pediatrics | 2501 N Orange Ave Ste 586, Orlando, FL 32804-4603 | 2019-12-31 |
| 1396250098 | Advanced Kid's Care | Pediatrics | 98 Terra Mango Loop, Unit 12, Orlando, FL 32835 | 2017-12-05 |
| 1467977454 | Physician Associates LLC | Pediatrics | 14065 Town Loop Blvd Ste 300, Orlando, FL 32837-6199 | 2017-08-10 |
| 1609320837 | Starus Pediatrics LLC | Pediatrics | 6001 Vineland Rd Ste 103, Orlando, FL 32819-7829 | 2016-08-04 |
| 1942656517 | Vijay Mehta | Pediatrics | 60 W Gore St # Mp373, Orlando, FL 32806 | 2016-05-12 |
| 1124401674 | Kelsey Wehrenberg | Pediatrics | 83 Columbia St Ste 202, Orlando, FL 32806 | 2015-07-01 |
| 1396138319 | Premier Physician Associates LLC | Pediatrics | 13651 Hunters Oak Dr, Ste 101, Orlando, FL 32837-7679 | 2015-03-16 |
| 1073917076 | Abdollah Iravani Md Pa | Pediatrics | 2106 N Orange Ave # 100, Orlando, FL 32804-5535 | 2014-10-20 |
| 1720407620 | Christopher Dudek | Pediatrics | 86 W Underwood St Ste 200, Orlando, FL 32806-1110 | 2014-04-08 |
| Find all providers in ORLANDO | ||||
Please comment or provide details below to improve the information on TLC PEDIATRIC & ADOLESCENT MEDICINE, P.A..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.