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Organization

NIGHT LITE PEDIATRIC CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIELLE MARIE LOPEZ (MANAGER CREDENTIALING/ENROLLMENT)
(516) 207-7936
Entity
Organization

Contact information

Practice address
5900 S JOHN YOUNG PKWY, ORLANDO, FL 32839-3716
(407) 398-6470
(407) 894-6872
Mailing address
1 HOLLOW LN STE 301, NEW HYDE PARK, NY 11042-1215
(516) 207-7936
(516) 207-7936

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0061521
FL

Other

Enumeration date
03/27/2007
Last updated
01/21/2025
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