OrganizationActive
Pediatric Neurology PA
NPI 1417129602 · Pediatric Neurodevelopmental Disabilities Physician · Orlando, FL
Provider details
- NPI number
- 1417129602
- Entity type
- Organization
- Primary specialty
- Pediatric Neurodevelopmental Disabilities PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Emmanuel Vega, Administrator(407) 293-1122
- License
- ME81662 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7485 Sandlake Commons Blvd
Orlando, FL 32819-8034
Phone: (407) 293-1122
Fax: (407) 253-2170
Approximate (ZIP-level) locationGet directions
Mailing address
1245 W Fairbanks Ave Ste 305
Winter Park, FL 32789-4878
Registry dates
- Enumerated
- 2008-03-27
- Last updated
- 2020-08-05
- Certified
- 2020-08-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.