Provider Demographics
NPI:1083606982
Name:DOS PEDIATRICS, PA
Entity Type:Organization
Organization Name:DOS PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALONSO-LEJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-381-5533
Mailing Address - Street 1:5142 CURRY FORD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8744
Mailing Address - Country:US
Mailing Address - Phone:407-381-5533
Mailing Address - Fax:407-381-1142
Practice Address - Street 1:5142 CURRY FORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-8744
Practice Address - Country:US
Practice Address - Phone:407-381-5533
Practice Address - Fax:407-381-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD21806Medicare UPIN
FLD050677Medicare UPIN