Healthcare Provider Details

I. General information

NPI: 1346553526
Provider Name (Legal Business Name): ALL MY KIDS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N PARK AVE #106
APOPKA FL
32712-3634
US

IV. Provider business mailing address

515 N PARK AVE #106
APOPKA FL
32712-3634
US

V. Phone/Fax

Practice location:
  • Phone: 407-814-4934
  • Fax: 407-814-4936
Mailing address:
  • Phone: 407-814-4934
  • Fax: 407-814-4936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME86243
License Number StateFL

VIII. Authorized Official

Name: DR. MARIELY MORALES-MURRAY
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 407-814-4934