Provider Demographics
NPI:1922370972
Name:SOUTH ORLANDO PEDIATRICS PLLC
Entity Type:Organization
Organization Name:SOUTH ORLANDO PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEDROSA-ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-422-2255
Mailing Address - Street 1:100 W GORE ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1044
Mailing Address - Country:US
Mailing Address - Phone:407-422-2255
Mailing Address - Fax:407-839-4659
Practice Address - Street 1:100 W GORE ST
Practice Address - Street 2:SUITE 305
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1044
Practice Address - Country:US
Practice Address - Phone:407-422-2255
Practice Address - Fax:407-839-4659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty