OrganizationActive
Aqua Blue Pediatrics PLLC
NPI 1619829900 · Pediatrics Physician · Ormond Beach, FL
Provider details
- NPI number
- 1619829900
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Brandon Betancourt, Practice Administrator(847) 854-9402
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
785 W Granada Blvd Ste 4
Ormond Beach, FL 32174-5163
Phone: (630) 464-4928
Street-level locationGet directions
Mailing address
7901 4th St N # 30729
St Petersburg, FL 33702-4305
Registry dates
- Enumerated
- 2026-02-10
- Last updated
- 2026-02-10
- Certified
- 2026-02-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.