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Organization
WICKHAM PEDIATRICS CENTER PS
Active
Organization
WICKHAM PEDIATRICS CENTER PS
Active
Other names
Dr. Kaneez Agha
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KANEEZ AGHA M.D. (OWNTER)
(321) 953-5364
Entity
Organization
Contact information
Practice address
199 S WICKHAM RD, MELBOURNE, FL 32904-1131
(321) 953-5364
(321) 953-9975
Mailing address
199 S WICKHAM RD, MELBOURNE, FL 32904-1131
(321) 953-5364
(321) 953-9975
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME70871
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250730700
—
FL
Enumeration date
02/05/2015
Last updated
02/05/2015
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