Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Neurology PA

Organization Pediatric Neurodevelopmental Disabilities Physician · NPI 1417129602

Pediatric Neurology PA is a Pediatric Neurodevelopmental Disabilities Physician in Orlando, Florida. Licensed in Florida. Registered with an NPI since 2008.

Licensed in
FL
In the registry since
2008
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7485 Sandlake Commons Blvd
Orlando, FL 32819-8034
Phone: (407) 293-1122
Fax: (407) 253-2170
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Neurodevelopmental Disabilities Physician (primary) Taxonomy 2080P0008X · Licence ME81662 (FL)

Record details

NPI number1417129602
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emmanuel Vega — Administrator · (407) 293-1122
NPI enumeratedMarch 27, 2008
Last updated in NPPESAugust 5, 2020
Certification dateAugust 5, 2020
Mailing address1245 W Fairbanks Ave Ste 305, Winter Park, FL 32789-4878

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