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NPI Code Detail

MEDICARE: BVL PEDIATRICS LLC

MEDICARE: BVL PEDIATRICS LLC
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
1261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902069826
Entity Type Code : Organization
Provider Name (Legal Business Name) : BVL PEDIATRICS LLC
Provider Business Mailing Address
First Line : 2535 BOGGY CREEK RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-3806
Country : US
Telephone Number : 407-344-0021
Fax Number : 407-344-0043
Provider Business Practice Location Address
First Line : 2535 BOGGY CREEK RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-3806
Country : US
Telephone Number : 407-344-0021
Fax Number : 407-344-0043
Authorized Official
Title or Position : OWNER
Name : AKBAR A QURESHI
Credential : MD
Telephone Number : 407-344-0021
Provider Enumeration Date : 07/10/2008
Last Update Date : 12/03/2013

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Directions to “BVL PEDIATRICS LLC ” Practice Location

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