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General NPI Number Information
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NPI Number | 1922370972
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Entity Type | Organization
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Legal Business Name | SOUTH ORLANDO PEDIATRICS PLLC
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 100 W GORE ST SUITE 305
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City | ORLANDO
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State | FL
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Zip | 32806-1044
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Country | US
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Telephone | 407-422-2255
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Fax | 407-839-4659
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Provider Business Mailing Address
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Address Line | 100 W GORE ST SUITE 305
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City | ORLANDO
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State | FL
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Zip | 32806-1044
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Country | US
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Telephone | 407-422-2255
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Fax | 407-839-4659
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EVELYN J PEDROSA-ROSADO
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Credential | MD
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Telephone | 407-422-2255
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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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