KIDSVILLE PEDIATRICS IV, P.A. - NPI 1508955212

Q: What is the provider's specialty?

The provider's specialty is Pediatrics with taxonomy code 208000000X.

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About Kidsville Pediatrics Iv, P.a. NPPES

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

KIDSVILLE PEDIATRICS IV, P.A. (NPI 1508955212) is a healthcare organization registered as a pediatrics in Orlando, Florida and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through September 10, 2026, maintains 2 additional practice locations, and lists Francelis I. Gonzalez, Ceo, as its authorized official.

NPPES Registry Identity

NPI1508955212

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameKIDSVILLE PEDIATRICS IV, P.A.

Location Address11886 LAKE UNDERHILL RDOrlando, FL 32825-4436

Mailing Address11886 Lake Underhill RdOrlando, FL 32825-4436 · (407) 447-7773 · Fax (407) 447-7804

Phone(407) 447-7773

Fax(407) 447-7804

Organization SubpartNo

Authorized OfficialFrancelis I. GonzalezCeo · (407) 447-7773

Enumeration DateOctober 12, 2006

Last NPPES UpdateAugust 13, 2019

✔ NPI 1508955212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in FL · ME-0074421

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.

11886 LAKE UNDERHILL RD, Orlando, FL 32825

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Secondary Practice Locations 2

Location 111886 Lake Underhill RdOrlando, FL 32825-4436 · Phone (407) 447-7773 · Fax (407) 447-7804

Location 212315 Lake Underhill Rd, Suite-BOrlando, FL 32828-4507 · Phone (407) 447-7773

Other Identifiers 1

Medicaid274349300FL

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 Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and more.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 10D1058612

Kidsville Pediatrics IV PA · Orlando, FL

Active · expires Sep 10, 2026

CLIA Number10D1058612

Laboratory TypePhysician Office

Certificate Effective DateSeptember 11, 2024

Certificate Expiration DateSeptember 10, 2026

Laboratory DirectorFrancelis I. Gonzalez

Laboratory Phone(407) 447-7773

Laboratory LocationKidsville Pediatrics IV PA11886 Lake Underhill Dr, Orlando, FL 32825

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 5

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

ANA C SOUTO NP

Nurse Practitioner (Pediatrics)