Organization
PM PEDIATRICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZIZ IMTIAZ MD (PHYSICIAN)
(407) 483-0672
Entity
Organization
Contact information
Practice address
1412 W VINE ST, KISSIMMEE, FL 34741-4051
(407) 483-0672
(407) 348-5882
Mailing address
1412 W VINE ST, KISSIMMEE, FL 34741-4051
(407) 483-0672
(407) 348-5882
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME94323
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274223300
—
FL
Enumeration date
05/14/2007
Last updated
05/21/2015
Update your record
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