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General NPI Number Information
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NPI Number | 1558606442
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Entity Type | Organization
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Legal Business Name | ORLANDO PEDIATRIC PSYCHIATRY LLC
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 1505 E MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32806-4818
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Country | US
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Telephone | 407-246-6620
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Fax | 407-203-2851
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Provider Business Mailing Address
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Address Line | 101 E MILLER ST
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City | ORLANDO
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State | FL
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Zip | 32806-2123
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Country | US
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Telephone | 407-246-6620
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Fax | 407-246-6621
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Authorized Official
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Title or Position | MANAGER
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Name | DR. AFTAB QADIR
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Credential | M.D.
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Telephone | 407-246-6620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME62388
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License Number State | FL
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