Organization
SUNSTATE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EHTERAM RAISSI-FARD MD (PRESIDENT)
(407) 333-2809
Entity
Organization
Contact information
Practice address
758 N SUN DR STE 108, LAKE MARY, FL 32746-2599
(407) 333-2809
(407) 333-2870
Mailing address
758 N SUN DR STE 108, LAKE MARY, FL 32746-2599
(407) 333-2809
(407) 333-2870
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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