Sunstate Pediatrics

NPI #1902067879 in Lake Mary, Florida

Provider Information

NPI Number: 1902067879
Entity Type: Organization
Organization Name: Sunstate Pediatrics
Primary Specialty: Pediatrics
Enumeration Date: Jun 23, 2008
Last Updated: Jun 23, 2008

Practice Location

Address: 758 N SUN DR STE 108
City: Lake Mary
State: Florida
ZIP Code: 32746-2599
Phone: (407) 333-2809

Authorized Official

Name: DR. EHTERAM RAISSI-FARD, MD
Title: PRESIDENT
Phone: (407) 333-2809

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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