EAST LAKE PEDIATRICS – NPI #1144343617
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.

EAST LAKE PEDIATRICS is a provider located in TRINITY, FL. NPPES has assigned the NPI number 1144343617 to EAST LAKE PEDIATRICS on April 09, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

The NPI profile was previously updated about 2 years ago on Feb 14, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EAST LAKE PEDIATRICS below.

NPI Profile for
EAST LAKE PEDIATRICS

NPI Number
1144343617
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EAST LAKE PEDIATRICS
Primary location
2137 LITTLE RD
TRINITY, FL 34655-4410
Phone: (727) 372-6760 Fax: (727) 372-6808
2 Other location(s):
200 Pine Ave N Ste A
Oldsmar, FL 34677-4646
Phone: (727) 372-6760
Fax: (727) 372-6808
4156 Woodlands Pkwy Ste B
Palm Harbor, FL 34685-3478
Phone: (727) 372-6760
Fax: (727) 372-6808
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MELISSA MONTGOMERY
MANAGER
Phone: (727) 372-6760
Updated
Certification Date
Feb 14, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EAST LAKE PEDIATRICS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherLICENSE NUMBERFLOS9496
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208000000X
- Pediatrics (Primary)
FL ME86866

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.