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Organization
PEDIATRIC SURGERY P.A.
Active
Organization
PEDIATRIC SURGERY P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S CHAET MD (PRESIDENT)
(407) 228-4774
Entity
Organization
Contact information
Practice address
1220 SLIGH BLVD, ORLANDO, FL 32806-1108
(407) 228-4774
(407) 228-2128
Mailing address
1220 SLIGH BLVD, ORLANDO, FL 32806-1108
(407) 228-4774
(407) 228-2128
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
NULL
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253269700
—
FL
Enumeration date
07/21/2006
Last updated
11/18/2015
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