Premium Medical Clinic PA

NPI #1730407420 in Orlando, Florida

Provider Information

NPI Number: 1730407420
Entity Type: Organization
Organization Name: Premium Medical Clinic PA
Primary Specialty: Pediatrics
Enumeration Date: May 6, 2010
Last Updated: Feb 1, 2012

Practice Location

Address: 12211 REGENCY VILLAGE DR
Address 2: SUITE 2
City: Orlando
State: Florida
ZIP Code: 32821-7813
Phone: (407) 212-3060

Authorized Official

Name: DR. SAFAA ABDEL-AL, M.D.
Title: PRESIDENT/OWNER
Phone: (407) 212-3060

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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