Healthcare Provider Details
I. General information
NPI: 1912839002
Provider Name (Legal Business Name): PEDIATRICS OF CENTRAL FLORIDA P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10920 MOSS PARK RD STE 118
ORLANDO FL
32832-6087
US
IV. Provider business mailing address
801 W OAK ST STE 101
KISSIMMEE FL
34741-6605
US
V. Phone/Fax
- Phone: 407-846-3455
- Fax: 407-846-3670
- Phone: 407-846-3455
- Fax: 407-846-3670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARY
K
JANARIOUS
Title or Position: PRESIDENT
Credential: MD
Phone: 407-846-3455