Provider Demographics
NPI:1073754594
Name:PHYSICIANS COLLABORATIVE ASSOCIATES INC
Entity Type:Organization
Organization Name:PHYSICIANS COLLABORATIVE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-362-6003
Mailing Address - Street 1:PO BOX 547066
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32854-7066
Mailing Address - Country:US
Mailing Address - Phone:407-362-6003
Mailing Address - Fax:407-362-6007
Practice Address - Street 1:425 W COLONIAL DR
Practice Address - Street 2:SUITE 302
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6863
Practice Address - Country:US
Practice Address - Phone:407-362-6003
Practice Address - Fax:407-362-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty