Provider Demographics
NPI:1093015620
Name:AJU GEORGE, M.D., P.A.
Entity Type:Organization
Organization Name:AJU GEORGE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AJU
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-226-3335
Mailing Address - Street 1:3307 KING GEORGE DR RM A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5903
Mailing Address - Country:US
Mailing Address - Phone:407-902-8186
Mailing Address - Fax:
Practice Address - Street 1:6068 S APOPKA VINELAND RD STE 10
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4449
Practice Address - Country:US
Practice Address - Phone:407-226-3335
Practice Address - Fax:407-264-8895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93445207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I41211Medicare UPIN