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General NPI Number Information
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NPI Number | 1952782559
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Entity Type | Organization
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Legal Business Name | SAFARI PEDIATRICS, PA
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 340 N WYMORE RD SUITE B
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City | WINTER PARK
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State | FL
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Zip | 32789-2823
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Country | US
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Telephone | 407-613-2473
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Fax | 407-613-2474
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Provider Business Mailing Address
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Address Line | PO BOX 490
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City | WINTER PARK
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State | FL
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Zip | 32790-0490
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Country | US
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Telephone | 407-613-2473
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Fax | 407-613-2474
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FATAN JAAFAR
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Credential | MD
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Telephone | 734-476-8989
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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 | ME110851
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License Number State | FL
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