MEDICARE: PEDIATRICS OF CENTRAL FLORIDA P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194493346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRICS OF CENTRAL FLORIDA P.A.

Provider Business Mailing Address
First Line	:	801 W OAK ST STE 101
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-6605
Country	:	US
Telephone Number	:	407-846-3455
Fax Number	:	407-846-7381

Provider Business Practice Location Address
First Line	:	3010 17TH ST
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34769-6011
Country	:	US
Telephone Number	:	407-891-0479
Fax Number	:	407-891-8775

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARY K JANARIOUS
Credential	:	MD
Telephone Number	:	407-846-3455

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	06/02/2026

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