Healthcare Provider Details

I. General information

NPI: 1467891531
Provider Name (Legal Business Name): ONE WORLD PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W STATE ROAD 434 STE 1010
LONGWOOD FL
32750
US

IV. Provider business mailing address

1400 W STATE ROAD 434 STE 1010
LONGWOOD FL
32750-3817
US

V. Phone/Fax

Practice location:
  • Phone: 407-644-9970
  • Fax: 407-644-6926
Mailing address:
  • Phone: 407-644-9970
  • Fax: 407-644-6926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAGDISH C AMBWANI
Title or Position: CEO
Credential: MD
Phone: 407-644-9970