Pediatric Medical Center LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC MEDICAL CENTER LLC

Practice address

836 Paul Street
Orlando, FL 32808

Phone

(407) 342-1896

Fax

(407) 369-4279

NPI assigned

Jun 7, 2023

Last updated

Jun 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ghazala Ahmed, M.D.NPI 1104961127

Title

President

Phone

(321) 947-5901

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ghazala Ijaz Ahmed, M.D.

  • Specialist
  • Orlando, FL
  • NPI 1104961127
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1235823691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 PAUL STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32808",
            "telephone_number": "407-342-1896",
            "fax_number": "407-369-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PAUL STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32808",
            "telephone_number": "407-342-1896",
            "fax_number": "407-369-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "GHAZALA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-947-5901",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.