Organization
TAVARES PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD AFZAL MD (OWNER)
(352) 394-3929
Entity
Organization
Contact information
Practice address
2754 DORA AVE, TAVARES, FL 32778-4970
(352) 508-5176
Mailing address
2754 DORA AVE, TAVARES, FL 32778-4970
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004771001
—
FL
Enumeration date
07/23/2021
Last updated
12/13/2023
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