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General NPI Number Information
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NPI Number | 1528370632
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Entity Type | Organization
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Legal Business Name | APH PEDIATRIC NEUROSURGERY PRACTICE
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 83 W COLUMBIA ST MP 303
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City | ORLANDO
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State | FL
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Zip | 32806-1101
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Country | US
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Telephone | 321-841-4717
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Fax |
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Provider Business Mailing Address
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Address Line | 83 W COLUMBIA ST # MP303
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City | ORLANDO
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State | FL
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Zip | 32806-1101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL COORDINATOR
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Name | JONI COCCAGNA
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Credential |
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Telephone | 321-841-4717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State | FL
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