Basic Information
| Provider Information | |||||||||
| NPI: | 1831427582 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A PLUS PEDIATRICS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 706 E GRAND HWY | ||||||||
| Address2: | |||||||||
| City: | CLERMONT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347113708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4074464117 | ||||||||
| FaxNumber: | 3524046955 | ||||||||
| Practice Location | |||||||||
| Address1: | 706 E GRAND HWY | ||||||||
| Address2: | |||||||||
| City: | CLERMONT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347113708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525574965 | ||||||||
| FaxNumber: | 3524046955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2009 | ||||||||
| LastUpdateDate: | 09/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | OTERO | ||||||||
| AuthorizedOfficialFirstName: | ANGELES | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3525574965 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME89425 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 274654900 | 05 | FL | MEDICAID | ME89425 | 01 | FL | STATE LICENSE | OTHER |