Organization
FLORIDA ENT ADULT & PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR FADHLI MD (OWNER)
(407) 343-9006
Entity
Organization
Contact information
Practice address
1162 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
(407) 343-9006
(407) 343-0999
Mailing address
1162 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
(407) 343-9006
(407) 343-0999
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAT 9108176
FL
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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