Healthcare Provider Details

I. General information

NPI: 1366871071
Provider Name (Legal Business Name): WATCH ME GROW PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2013
Last Update Date: 11/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3586 ALOMA AVE SUITE 2
WINTER PARK FL
32792-4010
US

IV. Provider business mailing address

8115 CRUSHED PEPPER AVE
ORLANDO FL
32817-2319
US

V. Phone/Fax

Practice location:
  • Phone: 407-677-4769
  • Fax: 407-677-4775
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS9823
License Number StateFL

VIII. Authorized Official

Name: DR. MRANALI SAWARDEKAR
Title or Position: OWNER
Credential: DO
Phone: 407-677-4769