Healthcare Provider Details

I. General information

NPI: 1760671457
Provider Name (Legal Business Name): PARSONS PEDIATRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 S PARSONS AVE SUITE D
BRANDON FL
33511-6064
US

IV. Provider business mailing address

908 S PARSONS AVE SUITE D
BRANDON FL
33511-6064
US

V. Phone/Fax

Practice location:
  • Phone: 813-655-9955
  • Fax:
Mailing address:
  • Phone: 813-655-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: AMARJIT S DHALIWAL
Title or Position: PRESIDENT
Credential:
Phone: 813-655-9955