Provider Demographics
NPI:1447556881
Name:UDITA JAHAGIRDAR MD PA
Entity Type:Organization
Organization Name:UDITA JAHAGIRDAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UDITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHAGIRDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-324-8589
Mailing Address - Street 1:101 N 8TH ST
Mailing Address - Street 2:STE1001
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3101
Mailing Address - Country:US
Mailing Address - Phone:407-324-8589
Mailing Address - Fax:407-321-8820
Practice Address - Street 1:101 N 8TH ST
Practice Address - Street 2:STE1001
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3101
Practice Address - Country:US
Practice Address - Phone:407-324-8589
Practice Address - Fax:407-321-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty