Provider Demographics
NPI:1912166935
Name:CORNERSTONE PEDIATRICS
Entity Type:Organization
Organization Name:CORNERSTONE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:M
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-785-8989
Mailing Address - Street 1:PO BOX 881027
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34988-1027
Mailing Address - Country:US
Mailing Address - Phone:772-785-8989
Mailing Address - Fax:772-785-6164
Practice Address - Street 1:380 SW PRIMA VISTA BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1984
Practice Address - Country:US
Practice Address - Phone:772-785-8989
Practice Address - Fax:772-785-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79897208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259749700Medicaid
FL58879OtherBCBS
FL259749700Medicaid