Healthcare Provider Details
I. General information
NPI: 1831427582
Provider Name (Legal Business Name): A PLUS PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2009
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
706 E GRAND HWY
CLERMONT FL
34711-3708
US
IV. Provider business mailing address
706 E GRAND HWY
CLERMONT FL
34711-3708
US
V. Phone/Fax
- Phone: 352-557-4965
- Fax: 352-404-6955
- Phone: 407-446-4117
- Fax: 352-404-6955
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME89425 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
ANGELES
I
OTERO
Title or Position: OWNER
Credential: MD
Phone: 352-557-4965