Provider Demographics
NPI:1518018878
Name:BAJPAI, KAMLESH N (DO)
Entity Type:Individual
Prefix:
First Name:KAMLESH
Middle Name:N
Last Name:BAJPAI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33526-0232
Mailing Address - Country:US
Mailing Address - Phone:352-518-2000
Mailing Address - Fax:352-567-0218
Practice Address - Street 1:2114 SEVEN SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-3908
Practice Address - Country:US
Practice Address - Phone:352-518-2000
Practice Address - Fax:352-567-0218
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13379207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME115860099Medicaid
ME115860099Medicaid
ME00574601Medicare PIN