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General NPI Number Information
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NPI Number | 1588819155
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Entity Type | Organization
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Legal Business Name | ALL PEDIATRICS, P.A.
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 2615 WINDGUARD CIR STE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7353
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Country | US
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Telephone | 813-333-9991
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Fax | 813-466-7482
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Provider Business Mailing Address
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Address Line | 2615 WINDGUARD CIR STE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7353
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Country | US
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Telephone | 813-333-9991
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Fax | 813-466-7482
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIVA PRASANNA DEVANABOYENA
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Credential |
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Telephone | 813-333-9991
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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 | ME94439
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License Number State | FL
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