Healthcare Provider Details

I. General information

NPI: 1639840325
Provider Name (Legal Business Name): A PLUS PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/23/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 CITRUS TOWER BLVD
CLERMONT FL
34711-6803
US

IV. Provider business mailing address

3155 CITRUS TOWER BLVD
CLERMONT FL
34711-6803
US

V. Phone/Fax

Practice location:
  • Phone: 352-242-1500
  • Fax: 353-242-0053
Mailing address:
  • Phone: 352-242-1500
  • Fax: 352-242-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LEROY O HARRISON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 352-557-4965