RDV SPORTSPLEX PEDIATRICS
NPI 1972679223
Pediatrics - Adolescent Medicine in Orlando, FL

Q: What is the provider's specialty?

The provider's specialty is Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.

Active since November 28, 2006CLIA 10D0950873 · Waiver

8701 MAITLAND SUMMIT BLVD, ORLANDO, FL 32810(407) 916-4522(407) 916-4525 Get Directions Write a Review

NPPES record last updated: February 20, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Rdv Sportsplex Pediatrics NPPES

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

RDV SPORTSPLEX PEDIATRICS (NPI 1972679223) is a healthcare organization registered as an adolescent medicine in Orlando, Florida and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through September 8, 2026 and lists Alberto Cobian, Vice President, as its authorized official.

NPPES Registry Identity

NPI1972679223

Entity TypeOrganization

Primary Taxonomy2080A0000X

Legal Business NamePRO STAR PEDIATRICS

Location Address8701 MAITLAND SUMMIT BLVDOrlando, FL 32810-5915

Mailing Address8701 Maitland Summit BlvdOrlando, FL 32810-5915 · (407) 916-4522 · Fax (407) 916-4525

Phone(407) 916-4522

Fax(407) 916-4525

Organization SubpartNo

Authorized OfficialAlberto CobianVice President · (407) 916-4522

Enumeration DateNovember 28, 2006

Last NPPES UpdateFebruary 20, 2014

✔ NPI 1972679223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

License✔ Licensed in FL · ME0036554

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

8701 MAITLAND SUMMIT BLVD, Orlando, FL 32810

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Other Names 1

Other NameRdv Sportsplex Pediatrics

Other Identifiers 4

Medicaid003657000FL

Medicaid041847101FL

Medicaid269488300FL

Medicare UPIND55150FL

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).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 10D0950873

Rdv Sportsplex Pediatrics · Orlando, FL

Active · expires Sep 8, 2026

CLIA Number10D0950873

Laboratory TypePhysician Office

Certificate Effective DateSeptember 9, 2024

Certificate Expiration DateSeptember 8, 2026

Laboratory DirectorLaritssa P. Cobian

Laboratory Phone(407) 916-4520

Laboratory LocationRdv Sportsplex Pediatrics8701 Maitland Summit Blvd, Orlando, FL 32810

CLIA data matches this NPI record on: Address Name

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.

DR. BARRY FRANKLIN PORTNOY M.D.

Family Medicine