PALM BEACH PEDIATRICS (NPI# 1629259072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629259072 |
| Entity Type | Organization |
| Organization Name | PALM BEACH PEDIATRICS |
| Practice Address |
12955 Palms West Dr Ste 100 Building 8 Loxahatchee FL 33470-4993 |
| Mailing Address |
1920 Palm Beach Lakes Blvd Ste 201 West Palm Beach FL 33409-3506 |
| Practice Telephone | 5617982468 |
| Practice Fax Number | 5617982733 |
| Mailing Telephone | 5615095009 |
| Mailing Fax Number | 5617381822 |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2020-08-26 |
| Authorized Official Name | KIMBERLY BRENNAN (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 5615095009 |
| Authorized Official Credential | MBA, CMPE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 379641800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528249976 | Palm Beach Pediatrics | Psychologist | 6080 Boynton Beach Blvd Ste 240, Boynton Beach, FL 33437-3586 | 2007-11-14 |
| Street Address |
12955 PALMS WEST DR STE 100 BUILDING 8 |
| City | LOXAHATCHEE |
| State | FL |
| Zip Code | 33470-4993 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700887049 | Sandra Smith Harmon | Pediatrics | 12955 Palms West Dr, Ste 100, Building 8, Loxahatchee, FL 33470-4993 | 2005-08-09 |
| 1831623602 | Palm Beach Surgical Associates, LLC | Surgery | 12955 Palms West Dr, Suite 101, Loxahatchee, FL 33470-4993 | 2017-04-18 |
| 1295286235 | Recovery Resort of The Palm Beaches LLC | Substance Abuse Rehabilitation Facility | 12955 Palms West Dr, Suite 202, Loxahatchee, FL 33470-4993 | 2016-10-14 |
| 1104132927 | Ricardo Aleman Chinea | Family Medicine | 12955 Palms West Dr, Ste 101, Loxahatchee, FL 33470-4993 | 2010-08-31 |
| 1164616157 | Mohammad M. Yaqub | Internal Medicine | 12955 Palms West Dr, Suite 201, Loxahatchee, FL 33470-4993 | 2007-09-01 |
| 1487730552 | Jennifer Christie Goodwin | Pediatrics | 12955 Palms West Dr, Building 8, Suite 100, Loxahatchee, FL 33470-4993 | 2006-10-31 |
| 1427139328 | Prettelt Center for Family Health Pa | Family Medicine | 12955 Palms West Dr, #101, Loxahatchee, FL 33470-4993 | 2006-10-18 |
| 1922189919 | Javier E Prettelt | Family Medicine | 12955 Palms West Dr, #101, Loxahatchee, FL 33470-4993 | 2006-10-18 |
| 1598854754 | Edgar Alberto Prettelt | Family Medicine | 12955 Palms West Dr, Building 8 . Suite 101, Loxahatchee, FL 33470-4993 | 2006-10-12 |
| 1457457319 | Lesa S Wright | Anesthesiology | 12955 Palms West Dr, Building 8, #101, Loxahatchee, FL 33470-4993 | 2006-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922638139 | Jang Nga Zeng | Physician Assistant | 5980 Kingfisher Blvd, Westlake, FL 33470 | 2020-01-16 |
| 1295290393 | Truepartners Westlake Emergency Specialists Pllc | Emergency Medicine | 16750 Persimmon Blvd, Westlake, FL 33470 | 2019-02-04 |
| 1952870818 | Luz Miryan Alexandra Torrente | Behavior Technician | 15932 75th Ln, Loxahatchee, FL 33470 | 2018-11-20 |
| 1508365495 | Simone E Mack | Counselor | 17334 W. Sycamore Dr., Loxahatchee, FL 33470 | 2018-02-06 |
| 1578083218 | Lugdie Marguerite Jonassaint | Registered Nurse | 14842-69 Street N., Treasured Lives Alf Inc C/o Lugdie Jonassaint, Loxahatchee, FL 33470 | 2017-06-23 |
| 1255877932 | Jose Desmarais | Nurse Practitioner | 12953 Palms West Dr Ste 102, Loxahatchee, FL 33470 | 2017-01-18 |
| 1457704314 | Premier Transitions Mht LLC | Internal Medicine | 17888 67th Court North, Loxahatchee, FL 33470 | 2016-07-15 |
| 1851747083 | Groves Dental Care P.a. | Clinic/Center | 15673 Southern Blvd., 109, Loxahatchee Groves, FL 33470 | 2016-05-06 |
| 1376959486 | Yun-long Chi | Acupuncturist | 12957 Palms West Dr Ste 201, Loxahatchee, FL 33470 | 2014-07-09 |
| 1629334081 | Kui-tzu Victoria Feng | Internal Medicine | 12957 Palms West Dr Ste 204, Loxahatchee, FL 33470 | 2012-04-10 |
| Find all providers in zip 33470 | ||||
| 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 |
|---|---|---|---|---|
| 1962675769 | Dionne M Skervin | Pediatrics | 12955 Palms West Drive #100, Palm Beach Pediatrics, Pa, Loxahatchee, FL 33470-9212 | 2008-04-12 |
| 1689660151 | Abimbola Odusanya | Pediatrics | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2005-09-21 |
| 1093717514 | Jennifer Griffiths Riddle | Pediatrics | 12955 Palms West Dr Ste 100, Palm Beach Pediatrics, Pa, Loxahatchee, FL 33470-9212 | 2005-08-15 |
| 1700887049 | Sandra Smith Harmon | Pediatrics | 12955 Palms West Dr, Ste 100, Building 8, Loxahatchee, FL 33470-4993 | 2005-08-09 |
| 1932100237 | Jonell Young Mahoney | Pediatrics | 12983 Southern Blvd Ste 100, Loxahatchee, FL 33470-9254 | 2005-08-09 |
| 1639638919 | Dilsa Marie Souffrant | Pediatrics | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2019-03-17 |
| 1083102941 | Hoon Kim | Pediatrics | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2018-04-26 |
| 1659868966 | Adrien Carl Ennis | Pediatrics | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2018-04-23 |
| 1932697273 | Glenda Zamora | Pediatrics | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2018-04-23 |
| 1679072367 | Konstantin Chernitskiy | Pediatrics | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2018-02-07 |
| Find all providers in LOXAHATCHEE | ||||
| City | LOXAHATCHEE |
| Zip Code | 33470 |
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| 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.