{"npi":"1508002072","type":"NPI-2","status":"active","name":{"display":"Pediatric Ent, LLC","other":[],"organization_name":"PEDIATRIC ENT, LLC","authorised_official":"David Malis"},"specialty":{"primary_taxonomy":"207YP0228X","primary_taxonomy_description":"Pediatric Otolaryngology Physician","slug":"pediatric-otolaryngology-physician","schema_org_specialty":null,"all":[{"code":"207YP0228X","description":"Pediatric Otolaryngology Physician","primary":true,"state":"FL","license":"ME90348"}]},"addresses":[{"purpose":"LOCATION","street_1":"1499 S HARBOR CITY BLVD STE 303","city":"MELBOURNE","state":"FL","postal_code":"329013245","country_code":"US","phone":"3212545437","fax":"3212544543"},{"purpose":"MAILING","street_1":"1499 S HARBOR CITY BLVD STE 303","city":"MELBOURNE","state":"FL","postal_code":"329013245","country_code":"US","phone":"3212545437","fax":"3212544543"}],"license":{"state":"FL","number":"ME90348"},"identifiers":[{"type_code":"01","label":"Other","value":"01269821","state":"FL","issuer":"MEDICAID HMO - AMERIGROUP"},{"type_code":"01","label":"Other","value":"2258392","state":"FL","issuer":"MEDICAID HMO - UNITED HEALTH CARE"},{"type_code":"01","label":"Other","value":"332181","state":"FL","issuer":"MEDICAID HMO - WELLCARE"},{"type_code":"05","label":"Medicaid","value":"271247400","state":"FL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20091021000475","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"FL","pac_id":"1153468319"}]},"enumeration_date":"2009-01-05","last_updated":"2014-04-18","_meta":{"source":"NPPES","snapshot_date":"2014-04-18","doc_url":"https://findmynpi.com/api"}}