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Contact Information

PRO STAR PEDIATRICS
8701 MAITLAND SUMMIT BLVD
ORLANDO, FL32810-5915
 Phone: 407-916-4522
 Fax: 407-916-4525
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PRO STAR PEDIATRICS

NPI # 1972679223
LBN Legal business name PRO STAR PEDIATRICS
Authorized official ALBERTO COBIAN - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/28/2006
Last updated 02/20/2014 - About 12 years ago
Identifiers
FL License # ME0036554
FL Medicaid 003657000
FL Medicaid 041847101
FL Medicaid 269488300
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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