1992746879 NPI number — AFTER HOURS PEDIATRICS, INC.

Table of content: (NPI 1992746879)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992746879 NPI number — AFTER HOURS PEDIATRICS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AFTER HOURS PEDIATRICS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AFTER HOURS PEDIATRIC PRACTICES
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992746879
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 COCONUT PALM DR STE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33619-8362
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 COCONUT PALM DR STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-775-4030
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEVY
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
813-775-4030

Provider Taxonomy Codes

  • Taxonomy code: 2080P0204X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: B901M . This is a "BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 300009 . This is a "AVMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: B901P . This is a "BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: B911G . This is a "BSFL" identifier . This identifiers is of the category "OTHER".
  • Identifier: B908R . This is a "BSFL" identifier . This identifiers is of the category "OTHER".
  • Identifier: B900A . This is a "BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 216599 . This is a "STAYWELL (CAID)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5016562 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7977521 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: B902C . This is a "BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: B903E . This is a "BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V0076701 . This is a "CITRUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6365205005 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: B901N . This is a "BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: B903V . This is a "BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1760785 . This is a "UNITED HEALTHCARE - PPO P" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 216599 . This is a "HEALTHEASE (CAID)" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 6365205006 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: B908W . This is a "BSFL" identifier . This identifiers is of the category "OTHER".




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