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JACKSONVILLE PEDIATRIC ASSOCIATES
NPI 1720619422
Pediatrics in St Johns, FL

Active since January 31, 2020
155 BARTRAM MARKET DR STE 120, ST JOHNS, FL 32259(904) 650-2193(904) 201-6350 Get Directions Write a Review

NPPES record last updated: May 19, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 19, 2021, Jan 31, 2020 (2 updates tracked since 2020).

About Jacksonville Pediatric Associates NPPES

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

JACKSONVILLE PEDIATRIC ASSOCIATES (NPI 1720619422) is a healthcare organization registered as a pediatrics in St Johns, Florida and active in the NPI registry since January 2020. The organization lists Patricia Corsiatto, Director, as its authorized official.

NPPES Registry Identity

NPI1720619422
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIATRIC ASSOCIATES OF NORTHEAST FLORIDA, LLC
Location Address155 BARTRAM MARKET DR STE 120St Johns, FL 32259-4582
Mailing Address900 S Pine Island Rd Ste 800Plantation, FL 33324-3923 · (954) 967-6400 · Fax (954) 965-7339
Phone(904) 650-2193
Fax(904) 201-6350
Organization SubpartNo
Authorized OfficialPatricia CorsiattoDirector · (954) 965-7331
Enumeration DateJanuary 31, 2020
Last NPPES UpdateMay 19, 20212 updates tracked since enumeration
NPPES CertifiedMay 19, 2021
✔ NPI 1720619422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
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.
155 BARTRAM MARKET DR STE 120, St Johns, FL 32259
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Other Names 1

Doing Business AsJacksonville Pediatric Associates

Other Identifiers 1

Medicaid011962603FL

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

Other Providers at the Same Location NPPES 4

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

SALTZMAN, TANIS, PITTELL, LEVIN AND JACOBSON, LLC
Pediatrics
155 BARTRAM MARKET DR STE 120
ST JOHNS, FL 32259
St. Johns County (904) 650-2193
SYLVIA LYN YARBROUGH PA-C
Physician Assistant (Medical)
155 BARTRAM MARKET DR STE 120
ST JOHNS, FL 32259
St. Johns County (904) 650-2193
VIVIANA SMITH VAZQUEZ MD
Pediatrics
155 BARTRAM MARKET DR STE 120
ST JOHNS, FL 32259
St. Johns County (904) 650-2193
GISELLE KHADINE HABET MD
Pediatrics
155 BARTRAM MARKET DR STE 120
ST JOHNS, FL 32259
St. Johns County (904) 650-2193

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 Pediatric Associates Of Northeast Florida, LLC's NPI number?

The NPI number for Pediatric Associates Of Northeast Florida, LLC is 1720619422. It was assigned to this organization in the NPPES registry on January 31, 2020. The provider is doing business as Jacksonville Pediatric Associates.

Where is Pediatric Associates Of Northeast Florida, LLC located?

Pediatric Associates Of Northeast Florida, LLC is located at 155 Bartram Market Dr Ste 120, St Johns, FL 32259. The listed phone number is (904) 650-2193.

What is Pediatric Associates Of Northeast Florida, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Pediatric Associates Of Northeast Florida, LLC was last updated on May 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.