Provider Demographics
NPI:1215403464
Name:PREMIER PHYSICIANS ORLANDO LLC
Entity Type:Organization
Organization Name:PREMIER PHYSICIANS ORLANDO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-644-2218
Mailing Address - Street 1:331 N MAITLAND AVE STE C1
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4754
Mailing Address - Country:US
Mailing Address - Phone:407-644-2218
Mailing Address - Fax:407-644-9260
Practice Address - Street 1:331 N MAITLAND AVE STE C1
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4754
Practice Address - Country:US
Practice Address - Phone:407-644-2218
Practice Address - Fax:407-644-9260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty