Provider Demographics
NPI:1467640060
Name:MARILYN G LAJOIE M D D C PA
Entity Type:Organization
Organization Name:MARILYN G LAJOIE M D D C PA
Other - Org Name:LAJOIE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:LAJOIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-226-3388
Mailing Address - Street 1:5900 TURKEY LAKE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4216
Mailing Address - Country:US
Mailing Address - Phone:404-226-3388
Mailing Address - Fax:407-226-3399
Practice Address - Street 1:5900 TURKEY LAKE RD
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4216
Practice Address - Country:US
Practice Address - Phone:404-226-3388
Practice Address - Fax:407-226-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87692207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG849Medicare PIN
FLU03460Medicare UPIN