Healthcare Provider Details

I. General information

NPI: 1740232123
Provider Name (Legal Business Name): ALL ABOUT KIDS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8961 CONROY WINDERMERE RD
ORLANDO FL
32835-3127
US

IV. Provider business mailing address

8500 COMMODITY CIR
ORLANDO FL
32819-9001
US

V. Phone/Fax

Practice location:
  • Phone: 407-354-0717
  • Fax:
Mailing address:
  • Phone: 407-354-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME46892
License Number StateFL

VIII. Authorized Official

Name: MR. A.J. MCHAFFIE
Title or Position: CEO
Credential:
Phone: 407-354-0717