Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Aqua Blue Pediatrics PLLC

Organization Pediatrics Physician · NPI 1619829900

Aqua Blue Pediatrics PLLC is a Pediatrics Physician in Ormond Beach, Florida. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

785 W Granada Blvd Ste 4
Ormond Beach, FL 32174-5163
Phone: (630) 464-4928
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1619829900
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brandon Betancourt — Practice Administrator · (847) 854-9402
NPI enumeratedFebruary 10, 2026
Last updated in NPPESFebruary 10, 2026
Certification dateFebruary 10, 2026
Mailing address7901 4th St N # 30729, St Petersburg, FL 33702-4305

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