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
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