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General NPI Number Information
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NPI Number | 1114975133
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Entity Type | Organization
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Legal Business Name | PEDIATRICIANS CARE UNIT
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 357 WEKIVA SPRINGS ROAD
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City | LONGWOOD
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State | FL
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Zip | 32779
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Country | US
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Telephone | 407-862-1163
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Fax | 407-774-1877
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Provider Business Mailing Address
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Address Line | 357 WEKIVA SPRINGS ROAD
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City | LONGWOOD
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State | FL
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Zip | 32779
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Country | US
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Telephone | 407-862-1163
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Fax | 407-774-1877
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. JOSEPH A CANNIZZARO
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Credential | M.D.
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Telephone | 407-862-1163
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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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