Provider Demographics
NPI:1285667139
Name:SOHRAB GERAMI, M.D., PA.
Entity Type:Organization
Organization Name:SOHRAB GERAMI, M.D., PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SOHRAB
Authorized Official - Middle Name:
Authorized Official - Last Name:GERAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-896-7111
Mailing Address - Street 1:2320 N ORANGE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5506
Mailing Address - Country:US
Mailing Address - Phone:407-896-7111
Mailing Address - Fax:407-894-4018
Practice Address - Street 1:2320 N ORANGE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5506
Practice Address - Country:US
Practice Address - Phone:407-896-7111
Practice Address - Fax:407-894-4018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME17968174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0583561000Medicaid
FLD55395Medicare UPIN
FL48683ZMedicare ID - Type UnspecifiedINDIVIDUAL NUMBER
FL0583561000Medicaid