CMS-1500 Box 24J / 33a • NPI
1396250098
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
208000000X (CMS 37)
Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)
Box 32 Service Location & ZIP+4
98 TERRA MANGO LOOP, UNIT 12, ORLANDO, FL, 32835
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1396250098 (ADVANCED KID'S CARE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1396250098 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED KID'S CARE |
| Plain-English Specialty | Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: 208000000X (Pediatrics) |
| Certifying / Licensing Body | American Board of Pediatrics (ABP) |
| Practice Location Address | 98 TERRA MANGO LOOP, UNIT 12, ORLANDO, FL, 32835 |
| Practice Telephone / Fax | Tel: (419) 819-7137 |
| Administrative Mailing Address | 5049 LATROBE DR, WINDERMERE, FL, 34786-8914 |
| Enumeration & Last Sync | Enumerated: 2017-12-05 | CMS Record Updated: 2017-12-05 |
| Authorized Official | BERNADETTE ANTONYRAJAH (Director) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208000000X)
What Does Taxonomy Code 208000000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208000000X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED KID'S CARE)
Typical CPT / Diagnostic Procedures:- Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
- Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
- Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
- Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
- Pediatric Asthma Nebulization & Spirometry Evaluation
- Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
- WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
- Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
- Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: FL | License: ME113681 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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