Provider Demographics
NPI:1538112487
Name:ORLANDO HOSPITALISTS LLC
Entity Type:Organization
Organization Name:ORLANDO HOSPITALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:PRAKASH
Authorized Official - Last Name:MUTTREJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-650-0018
Mailing Address - Street 1:PO BOX 2032
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-2032
Mailing Address - Country:US
Mailing Address - Phone:407-650-0018
Mailing Address - Fax:407-650-0118
Practice Address - Street 1:818 MAIN LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3727
Practice Address - Country:US
Practice Address - Phone:407-650-0018
Practice Address - Fax:407-650-0118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073769174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty