Healthcare Provider Details

I. General information

NPI: 1174438410
Provider Name (Legal Business Name): WONDER PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 SMITHFIELD DR
ORLANDO FL
32837-7477
US

IV. Provider business mailing address

2909 SMITHFIELD DR
ORLANDO FL
32837-7477
US

V. Phone/Fax

Practice location:
  • Phone: 407-491-5616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: IQRA BHATTI
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S. CCC-SLP
Phone: 407-491-5616