# PEDIATRIC SURGERY P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023039351
- **Authorized official:** MARK S CHAET MD (PRESIDENT)
- **Authorized official phone:** (407) 228-4774

## Contact information

- **Practice address:** 1220 SLIGH BLVD, ORLANDO, FL 32806-1108
- **Practice address phone:** (407) 228-4774
- **Practice address fax:** (407) 228-2128
- **Mailing address:** 1220 SLIGH BLVD, ORLANDO, FL 32806-1108
- **Mailing address phone:** (407) 228-4774
- **Mailing address fax:** (407) 228-2128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 11/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 253269700 | — | FL |