Healthcare Provider Details

I. General information

NPI: 1316010952
Provider Name (Legal Business Name): ORLANDO PEDIATRIC PULMONARY AND SLEEP ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 W FAIRBANKS AVE
WINTER PARK FL
32789-3385
US

IV. Provider business mailing address

2660 W FAIRBANKS AVE
WINTER PARK FL
32789-3385
US

V. Phone/Fax

Practice location:
  • Phone: 407-898-2767
  • Fax: 407-898-9443
Mailing address:
  • Phone: 407-898-2767
  • Fax: 407-898-9443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AKINYEMI AJAYI
Title or Position: OWNER
Credential: MBBS
Phone: 407-898-2767