Healthcare Provider Details
I. General information
NPI: 1073932794
Provider Name (Legal Business Name): CENTRAL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2014
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1128 KELTON AVE
OCOEE FL
34761-3175
US
IV. Provider business mailing address
PO BOX 930
WINDERMERE FL
34786-0930
US
V. Phone/Fax
- Phone: 407-290-5533
- Fax:
- Phone: 407-290-5533
- Fax: 407-290-8333
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME70278 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
MUHAMMAD
A
SALEEM
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 407-290-5533