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General NPI Number Information
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NPI Number | 1245499367
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Entity Type | Organization
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Legal Business Name | EXCEL PEDIATRICS
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 265 CITRUS TOWER BLVD STE # 102
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City | CLERMONT
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State | FL
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Zip | 34711-1908
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Country | US
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Telephone | 352-394-3929
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Fax | 352-394-6446
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Provider Business Mailing Address
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Address Line | 265 CITRUS TOWER BLVD STE # 102
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City | CLERMONT
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State | FL
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Zip | 34711-1908
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Country | US
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Telephone | 352-394-3929
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Fax | 352-394-6446
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Authorized Official
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Title or Position | MD
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Name | DR. 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 | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | ME72542
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License Number State | FL
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