Healthcare Provider Details

I. General information

NPI: 1598279812
Provider Name (Legal Business Name): WP PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 GLENWOOD DR
WINTER PARK FL
32792
US

IV. Provider business mailing address

2340 GLENWOOD DR
WINTER PARK FL
32792-3314
US

V. Phone/Fax

Practice location:
  • Phone: 407-975-0681
  • Fax: 407-975-0683
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DHABIA F AL-NAJJAR
Title or Position: MGR
Credential: MD
Phone: 407-975-0681