Provider Demographics
NPI:1194395772
Name:GROWING TOGETHER PEDIATRICS, LLC
Entity Type:Organization
Organization Name:GROWING TOGETHER PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCHAFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-770-1414
Mailing Address - Street 1:5164 S. CONWAY RD.
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812
Mailing Address - Country:US
Mailing Address - Phone:407-770-1414
Mailing Address - Fax:
Practice Address - Street 1:1583 E SILVER STAR RD
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2553
Practice Address - Country:US
Practice Address - Phone:407-770-1414
Practice Address - Fax:407-447-8876
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GROWING TOGETHER PEDIATRICS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty