Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Premium Medical Clinic PA

Organization Pediatrics Physician · NPI 1730407420

Premium Medical Clinic PA provides Pediatrics Physician services 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 Not confirmed with CMS for 14 years — call before visiting
Phone: (407) 212-3060
Fax: (877) 644-7808
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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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