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PREMIUM MEDICAL CLINIC PA
NPI 1730407420
Pediatrics in Orlando, FL

Active since May 06, 2010
12211 REGENCY VILLAGE DR, SUITE 2, ORLANDO, FL 32821(407) 212-3060(877) 644-7808 Get Directions Write a Review

NPPES record last updated: February 1, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Premium Medical Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIUM MEDICAL CLINIC PA (NPI 1730407420) is a healthcare organization registered as a pediatrics in Orlando, Florida and active in the NPI registry since May 2010. The organization lists Safaa Abdel-al, President/owner, as its authorized official.

NPPES Registry Identity

NPI1730407420
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePREMIUM MEDICAL CLINIC PA
Location Address12211 REGENCY VILLAGE DR, SUITE 2Orlando, FL 32821-7813
Mailing Address12211 Regency Village Dr, Suite 2Orlando, FL 32821-7813 · (407) 212-3060 · Fax (877) 644-7808
Phone(407) 212-3060
Fax(877) 644-7808
Organization SubpartNo
Authorized OfficialSafaa Abdel-alPresident/owner · (407) 212-3060
Enumeration DateMay 6, 2010
Last NPPES UpdateFebruary 1, 2012
✔ NPI 1730407420 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · ME97108
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
12211 REGENCY VILLAGE DR, Orlando, FL 32821
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Other Identifiers 2

Other1465PFL · Bcbs
Medicaid002150900FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premium Medical Clinic PA's NPI number?

The NPI number for Premium Medical Clinic PA is 1730407420. It was assigned to this organization in the NPPES registry on May 6, 2010.

Where is Premium Medical Clinic PA located?

Premium Medical Clinic PA is located at 12211 Regency Village Dr Suite 2, Orlando, FL 32821. The listed phone number is (407) 212-3060.

What is Premium Medical Clinic PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Premium Medical Clinic PA was last updated on February 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.