=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790973402
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TREE HOUSE PEDIATRICS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2007
-----------------------------------------------------
Last Update Date | 01/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9743 SELTEN WAY
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-736-8733
-----------------------------------------------------
Fax | 888-974-1815
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9743 SELTEN WAY
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-736-8733
-----------------------------------------------------
Fax | 888-974-1815
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/PEDIATRICIAN
-----------------------------------------------------
Name | DR. ANNETTE NICOLE NIELSEN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 407-736-8733
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | ME93223
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------