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 provides Pediatric Neurodevelopmental Disabilities Physician services 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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