Healthcare Provider Details

I. General information

NPI: 1851536841
Provider Name (Legal Business Name): LITTLE ANGELS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E IRLO BRONSON MEMORIAL HWY
SAINT CLOUD FL
34771-5806
US

IV. Provider business mailing address

1700 E IRLO BRONSON MEMORIAL HWY
SAINT CLOUD FL
34771-5806
US

V. Phone/Fax

Practice location:
  • Phone: 407-538-2971
  • Fax: 407-344-0043
Mailing address:
  • Phone: 407-538-2971
  • Fax: 407-344-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME0069091
License Number StateFL

VIII. Authorized Official

Name: DR. AKBAR A QURESHI
Title or Position: OWNER/PHYSICIAN
Credential: M.D
Phone: 407-538-2971