Organization
CHILDREN'S DOCTORS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PANITDA D TOOCHINDA M.D. (PRESIDENT)
(407) 913-2156
Entity
Organization
Contact information
Practice address
264 DOUGLAS AVE, ALTAMONTE SPRINGS, FL 32714-3336
(407) 862-8448
Mailing address
855 E SANDPIPER ST, APOPKA, FL 32712-2903
(407) 889-3175
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
ME29981
FL
305R00000X
Preferred Provider Organization
ME29981
FL
305S00000X
Point of Service
ME29981
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059989100
—
FL
Enumeration date
07/16/2014
Last updated
07/16/2014
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