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General NPI Number Information
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NPI Number | 1326503301
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Entity Type | Organization
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Legal Business Name | ADVANCED PEDIATRIC CENTER LLC
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 11/22/2019
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Provider Practice Location Address
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Address Line | 11331 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-247-2533
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Fax | 352-247-2535
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Provider Business Mailing Address
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Address Line | 11331 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-247-2533
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Fax | 352-247-2535
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | MUHAMMAD K SAMI
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Credential | MD
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Telephone | 352-247-2533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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