MEDICARE: PEDIATRIC HEALTH CARE

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	ME 62109	FL

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	:	1215063821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC HEALTH CARE

Provider Business Mailing Address
First Line	:	5308 S JOHN YOUNG PKWY
Second Line	:	SUITE 200
City	:	ORLANDO
State	:	FL
Zip	:	32839-7362
Country	:	US
Telephone Number	:	407-563-2821
Fax Number	:	407-240-9508

Provider Business Practice Location Address
First Line	:	5308 S JOHN YOUNG PKWY
Second Line	:	STE. 200
City	:	ORLANDO
State	:	FL
Zip	:	32839-7362
Country	:	US
Telephone Number	:	407-563-2821
Fax Number	:	407-240-9508

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. RAZA ALI
Credential	:	M.D.
Telephone Number	:	407-563-2821

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	03/01/2012

Similar Medicare Providers

1770523482 — DR. RAZA ALI M.D
Practice Location Address:

5308 S JOHN YOUNG PKWY , SUITE #200
ORLANDO, FL
32839-7362

Practice Phone: 407-240-9766
Practice Fax: 407-240-9508

1497836258 — MRS. VERONICA GARCIA PA-C
Practice Location Address:

5308 S JOHN YOUNG PKWY STE 200
ORLANDO, FL
32839-7362

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Practice Fax: 407-240-9508

1659446722 — GEROME ALEX CLEEFORD BELIARD MD
Practice Location Address:

5308 S JOHN YOUNG PKWY STE 300
ORLANDO, FL
32839-7362

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Practice Fax: 407-355-3383

1932221504 — PRIMARY CARE OF ORLANDO, INC.
Practice Location Address:

5308 S JOHN YOUNG PKWY , SUITE 100
ORLANDO, FL
32839-7362

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1215164363 — OB GYN OF GREATER ORLANDO LLC
Practice Location Address:

5308 S JOHN YOUNG PKWY STE 300
ORLANDO, FL
32839-7362

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1437593639 — WENDY GLENDA SINGLETARY MSN, ARNP, PNP-BC
Practice Location Address:

5308 S JOHN YOUNG PKWY STE 200
ORLANDO, FL
32839-7362

Practice Phone: 407-240-9766
Practice Fax:

Directions to “PEDIATRIC HEALTH CARE ” Practice Location

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