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General NPI Number Information
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NPI Number | 1114049822
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Entity Type | Organization
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Legal Business Name | WINDERMERE PEDIATRICS
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2101 PARK CENTER DR 100 & 130
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City | ORLANDO
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State | FL
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Zip | 32835-7626
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Country | US
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Telephone | 407-297-0080
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Fax | 407-295-3080
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Provider Business Mailing Address
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Address Line | 2101 PARK CENTER DR 100 & 130
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City | ORLANDO
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State | FL
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Zip | 32835-7626
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Country | US
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Telephone | 407-297-0080
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Fax | 407-295-3080
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GINNY L GUYTON
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Credential | MD
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Telephone | 407-297-0080
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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 | ME0051702
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License Number State | FL
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