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

Premium Medical Clinic PA

Organization Pediatrics Physician · NPI 1730407420

Premium Medical Clinic PA is a Pediatrics Physician in Orlando, Florida. Licensed in Florida. Registered with an NPI since 2010.

Licensed in
FL
In the registry since
2010
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

12211 Regency Village Dr Ste 2
Orlando, FL 32821-7813
Phone: (407) 212-3060
Fax: (877) 644-7808
Show map & directions

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

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence ME97108 (FL)

Record details

NPI number1730407420
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Safaa Abdel-Al — President/Owner · (407) 212-3060
NPI enumeratedMay 6, 2010
Last updated in NPPESFebruary 1, 2012
Mailing address12211 Regency Village Dr, Suite 2, Orlando, FL 32821-7813

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