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General NPI Number Information
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NPI Number | 1306934872
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Entity Type | Organization
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Legal Business Name | PERSONAL PEDIATRICS
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 7051 DR PHILLIPS BLVD SUITE 7
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-345-9929
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Fax | 407-447-8969
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Provider Business Mailing Address
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Address Line | 7051 DR PHILLIPS BLVD SUITE 7
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-345-9929
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Fax | 407-447-8969
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Authorized Official
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Title or Position | FRONT OFFICE LEAD
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Name | RUTHIE BAYO
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Credential |
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Telephone | 407-345-9929
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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 | ME45910
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License Number State | FL
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