MEDICARE: METRO ORLANDO PEDIATRICS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	ME70411	FL

General Provider Information

NPI Number	:	1396827846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO ORLANDO PEDIATRICS PA

Provider Business Mailing Address
First Line	:	855 OUTER RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6652
Country	:	US
Telephone Number	:	407-893-7377
Fax Number	:	407-896-8702

Provider Business Practice Location Address
First Line	:	855 OUTER RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6652
Country	:	US
Telephone Number	:	407-893-7377
Fax Number	:	407-896-8702

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. ANDREW GERNET SUMMERS
Credential	:	MD
Telephone Number	:	407-893-7377

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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