| Compassion Pediatrics Llc | |
|
4445 S Semoran Blvd Ste A Orlando FL 32822-2472 | |
| (407) 203-8957 | |
| (407) 985-1904 |
| Full Name | Compassion Pediatrics Llc |
|---|---|
| Speciality | Pediatrics |
| Location | 4445 S Semoran Blvd Ste A, Orlando, Florida |
| Authorized Official Name and Position | Lesley Kyle Bow (CEO) |
| Authorized Official Contact | 4074564591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassion Pediatrics Llc 4445 S Semoran Blvd Ste A Orlando FL 32822-2472 Ph: (407) 203-8957 | Compassion Pediatrics Llc 4445 S Semoran Blvd Ste A Orlando FL 32822-2472 Ph: (407) 203-8957 |
| NPI Number | 1194066761 |
|---|---|
| Provider Enumeration Date | 03/07/2013 |
| Last Update Date | 10/24/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 2365787249 |
|---|---|
| Medicare Enrollment ID | O20181220002626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194066761 | NPI | - | NPPES |
| 7100715220 | Medicaid | KY | |
| 008610700 | Medicaid | FL |
| Provider Name | Lesley Kyle Bow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356592968 PECOS PAC ID: 3375781180 Enrollment ID: I20130605000654 |
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