Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124319611 Individual Practitioner Male Practitioner

Dr. Dibanni Vasquez , MD

Pediatrics • Lake Park, FL

Professional Overview & Biography Verified Profile Summary

Dr. Dibanni Vasquez, MD is a registered healthcare professional specializing in Pediatrics in Lake Park, FL. Practice services are available at 500 US HIGHWAY 1 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

500 Us Highway 1

Lake Park, FL 334033598

Telephone 4078982767
Fax 4078989443
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Lake Park, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Lake Park, FL (4160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-08-07
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL ME 109534

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics - Pediatric Pulmonology

NUCC Taxonomy Code: 2080P0214X

State License FL ME109534

A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
119093800 (FL)

Secondary Practice Locations

561 Nw Lake Whitney Pl Ste 101

Port St Lucie, FL 349861624

Phone: 4078982767

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

20 Associated Practitioners
Dr. Shivani Verma , MD

Pediatrics - Pediatric Pulmonology

NPI 1043460231

Doctor of Medicine (M.D.)

Brooke Lavine

Nurse Practitioner - Pediatrics

NPI 1114741345
Mary Alice Leinbach , ARNP, CPNP

Nurse Practitioner - Pediatrics

NPI 1134203227

Advanced Registered Nurse Practitioner, Certified Pediatric Nurse Practitioner

Kristiauna Brough , APRN

Nurse Practitioner - Pediatrics

NPI 1154143352

Advanced Practice Registered Nurse

Dr. Anunya Hiranrattana , MD

Pediatrics - Pediatric Pulmonology

NPI 1174739619

Doctor of Medicine (M.D.)

Vanessa Cravatta , ARNP

Nurse Practitioner - Pediatrics

NPI 1205184900

Advanced Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 07, 2026

Registered at 500 US HIGHWAY 1, LAKE PARK, FL 334033598 (Tel: 4078982767)

📍
Updated Business Mailing Address August 07, 2026

Registered at 2660 W FAIRBANKS AVE, WINTER PARK, FL 327893385 (Tel: 4078982767)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 07, 2026

Pediatrics (License #ME109534 in FL)

NPI Profile Active May 06, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location May 06, 2015

Registered at 90 SW 3RD ST, APT 4308, MIAMI, FL 331302995 (Tel: 3059721073)

📍
Updated Business Mailing Address May 06, 2015

Registered at 90 SW 3RD ST, APT 4308, MIAMI, FL 331302995 (Tel: 3059721073)

👤
Provider Name / Credentials Updated May 06, 2015

Recorded as DIBANNI VASQUEZ, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 06, 2015

Pediatrics (License #ME 109534 in FL)

🟢
Initial NPI Registration & Enumeration May 02, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124319611
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 02, 2011
Last Update: August 07, 2026
Sole Proprietor: No

Mailing Address

2660 W Fairbanks Ave

Winter Park, FL 327893385

Phone: 4078982767

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.