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General NPI Number Information
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NPI Number | 1003258666
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Entity Type | Organization
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Legal Business Name | LEESBURG PEDIATRICS PA
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 8113 CENTRALIA CT
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City | LEESBURG
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State | FL
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Zip | 34788-7508
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Country | US
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Telephone | 352-435-7938
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Fax | 352-805-4145
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Provider Business Mailing Address
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Address Line | 8113 CENTRALIA CT
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City | LEESBURG
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State | FL
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Zip | 34788-7508
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Country | US
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Telephone | 352-435-7938
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Fax | 352-805-4145
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMMAD AFZAL
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Credential | MD
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Telephone | 352-394-3929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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