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NPI 1740104975

NPI 1740104975 : ALL WELL PEDIATRICS GROUP, P.A. : HUDSON, FL

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General NPI Number Information
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    NPI Number           |    1740104975
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    Entity Type          |    Organization 
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    Legal Business Name  |    ALL WELL PEDIATRICS GROUP, P.A. 
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Dates
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    Enumeration Date     |    08/10/2026
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    Last Update Date     |    08/10/2026
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Provider Practice Location Address
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    Address Line         |    7455 STATE ROAD 52 
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    City                 |    HUDSON
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    State                |    FL
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    Zip                  |    34667-6714
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    Country              |    US
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    Telephone            |    813-964-1800
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    Fax                  |    813-964-1880
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Provider Business Mailing Address
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    Address Line         |    17541 N DALE MABRY HWY 
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    City                 |    LUTZ
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    State                |    FL
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    Zip                  |    33548-4521
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    Country              |    US
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    Telephone            |    813-964-1800
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    Fax                  |    
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Authorized Official
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    Title or Position    |    COO
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    Name                 |     GOWTHAMAN  PANDIAN 
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    Credential           |    
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    Telephone            |    813-816-5124
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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       |    
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    License Number State |    
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