Provider Demographics
NPI:1043514862
Name:WORLD OF PEDIATRICS, LLC
Entity Type:Organization
Organization Name:WORLD OF PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARGIULO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-398-6470
Mailing Address - Street 1:327 W CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-3326
Mailing Address - Country:US
Mailing Address - Phone:407-483-0672
Mailing Address - Fax:
Practice Address - Street 1:4151 HUNTERS PARK LN
Practice Address - Street 2:SUITE 116
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-3617
Practice Address - Country:US
Practice Address - Phone:407-483-0672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-09
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99347208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3832208Medicaid
TN3832208Medicaid