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LIGHTHOUSE PEDIATRICS PLLC
NPI 1043630353
Pediatrics in St Augustine, FL

Active since April 25, 2014
100 WHETSTONE PL, SUITE 211, ST AUGUSTINE, FL 32086(904) 342-7648(904) 342-8567 Get Directions Write a Review

NPPES record last updated: April 25, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lighthouse Pediatrics Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIGHTHOUSE PEDIATRICS PLLC (NPI 1043630353) is a healthcare organization registered as a pediatrics in St Augustine, Florida and active in the NPI registry since April 2014. The organization lists Vincent Luz, Owner, as its authorized official.

NPPES Registry Identity

NPI1043630353
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameLIGHTHOUSE PEDIATRICS PLLC
Location Address100 WHETSTONE PL, SUITE 211St Augustine, FL 32086-5774
Mailing Address100 Whetstone Pl, Suite 211St Augustine, FL 32086-5774 · (904) 342-7648 · Fax (904) 342-8567
Phone(904) 342-7648
Fax(904) 342-8567
Organization SubpartNo
Authorized OfficialVincent LuzOwner · (904) 342-7648
Enumeration DateApril 25, 2014
✔ NPI 1043630353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · ME90727
Definition
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.
100 WHETSTONE PL, St Augustine, FL 32086
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2081536

Lighthouse Pediatrics · Saint Augustine, FL
Expired · Jul 27, 2026
CLIA Number10D2081536
Laboratory TypePhysician Office
Certificate Effective DateJuly 28, 2024
Certificate Expiration DateJuly 27, 2026
Laboratory DirectorJessica L. Stailey
Laboratory Phone(904) 342-7648
Laboratory LocationLighthouse Pediatrics4475 Us Hwy 1 South Suite 100, Saint Augustine, FL 32086
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICK ZIEMANN-GIMMEL MD
Anesthesiology
100 WHETSTONE PL
ST AUGUSTINE, FL 32086
St. Johns County (904) 819-4478
WILLIAM J OKTAVEC MD PA
Ophthalmology
100 WHETSTONE PL, SUITE 106
ST AUGUSTINE, FL 32086
St. Johns County (904) 826-3937
BERNARD R BORBELY MD
Internal Medicine (Pulmonary Disease)
100 WHETSTONE PL, SUITE208
ST AUGUSTINE, FL 32086
St. Johns County (904) 819-6800
DR. WALID OMAR MD
Family Medicine
100 WHETSTONE PL, SUITE 204
ST AUGUSTINE, FL 32086
St. Johns County (217) 720-3144
BETHANY ANN BROWN ARNP
Nurse Practitioner
100 WHETSTONE PL
SAINT AUGUSTINE, FL 32086
St. Johns County (904) 746-1095
FARGHALY MEDICAL, PLLC
Family Medicine
100 WHETSTONE PL, SUITE 208
ST AUGUSTINE, FL 32086
St. Johns County (904) 826-7932
DR. WILLIAM FRANCIS FOODY JR. M.D.
Internal Medicine (Gastroenterology)
100 WHETSTONE PL, STE 105
ST AUGUSTINE, FL 32086
St. Johns County (904) 829-9557
SCOTT D MCDOWALL PLLC
Internal Medicine (Nephrology)
100 WHETSTONE PL, SUITE 206
ST AUGUSTINE, FL 32086
St. Johns County (904) 547-2808

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lighthouse Pediatrics PLLC's NPI number?

The NPI number for Lighthouse Pediatrics PLLC is 1043630353. It was assigned to this organization in the NPPES registry on April 25, 2014.

Where is Lighthouse Pediatrics PLLC located?

Lighthouse Pediatrics PLLC is located at 100 Whetstone Pl Suite 211, St Augustine, FL 32086. The listed phone number is (904) 342-7648.

What is Lighthouse Pediatrics PLLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

What insurance does Lighthouse Pediatrics PLLC accept?

Health plans from Ambetter Health, Ambetter of Alabama and AvMed list Lighthouse Pediatrics PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lighthouse Pediatrics PLLC was last updated on April 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.