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Contact Information

BLOOMINGDALE PEDIATRIC ASS PA
4316 BELL SHOALS RD
VALRICO, FL33594
 Phone: 813-684-1881
 Fax: 813-685-0471
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for BLOOMINGDALE PEDIATRIC ASS PA · (Female)

NPI Number 1376617043
Status Active
Credentials
Entity Individual
Enumeration date 11/17/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME45712
  • Other 26208721 AETNA
  • Other 208721 AMERIGROUP
  • Other 62614 BCBS
  • Other 00559 HEAHCASE
  • Other 00559 STAYWELL
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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