Organization
EAST LAKE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MARIE MONTGOMERY (MANAGER)
(727) 372-6760
Entity
Organization
Contact information
Practice address
2137 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6760
(727) 372-6808
Mailing address
2137 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6760
(727) 372-6808
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME86866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS9496
LICENSE NUMBER
FL
Enumeration date
04/09/2007
Last updated
02/14/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up