Provider Demographics
NPI:1376588582
Name:PAL, ASHISH (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:
Last Name:PAL
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-2560
Mailing Address - Country:US
Mailing Address - Phone:407-898-8449
Mailing Address - Fax:407-898-8756
Practice Address - Street 1:181 WEBB DR
Practice Address - Street 2:SUITE B
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3944
Practice Address - Country:US
Practice Address - Phone:407-898-8449
Practice Address - Fax:407-898-8756
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74621174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253610200Medicaid
FLK3105Medicare ID - Type UnspecifiedMD
FL253610200Medicaid