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General NPI Number Information
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NPI Number | 1316183460
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Entity Type | Organization
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Legal Business Name | OVIEDO CHILDRENS HEALTH CENTER LLC
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Dates
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Enumeration Date | 12/19/2008
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Last Update Date | 04/28/2024
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Provider Practice Location Address
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Address Line | 870 CLARK ST STE 1000
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City | OVIEDO
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State | FL
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Zip | 32765-9270
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Country | US
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Telephone | 407-977-1135
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Fax | 407-977-9946
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Provider Business Mailing Address
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Address Line | 870 CLARK ST STE 1000
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City | OVIEDO
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State | FL
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Zip | 32765-9270
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Country | US
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Telephone | 407-977-1135
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Fax | 407-977-9946
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. SADIQ MANDANI
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Credential | M.D.
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Telephone | 407-977-1135
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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 | ME90618
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License Number State | FL
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