Provider Demographics
NPI:1316010952
Name:ORLANDO PEDIATRIC PULMONARY AND SLEEP ASSOCIATES PA
Entity Type:Organization
Organization Name:ORLANDO PEDIATRIC PULMONARY AND SLEEP ASSOCIATES PA
Other - Org Name:CHILDRENS LUNG, ASTHMA AND SLEEP SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKINYEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:407-898-2767
Mailing Address - Street 1:2660 W FAIRBANKS AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3385
Mailing Address - Country:US
Mailing Address - Phone:407-898-2767
Mailing Address - Fax:407-898-9443
Practice Address - Street 1:2660 W FAIRBANKS AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3385
Practice Address - Country:US
Practice Address - Phone:407-898-2767
Practice Address - Fax:407-898-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Multi-Specialty
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277213200Medicaid