Provider Demographics
NPI:1558810317
Name:ELITE ORTHOPEDICS AND SPORTS MEDICINE, PLLC
Entity Type:Organization
Organization Name:ELITE ORTHOPEDICS AND SPORTS MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEENESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHAJPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-575-1994
Mailing Address - Street 1:3200 SW 34TH AVE
Mailing Address - Street 2:BLDG 500, SUITE 502
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7456
Mailing Address - Country:US
Mailing Address - Phone:860-575-1994
Mailing Address - Fax:
Practice Address - Street 1:3200 SW 34TH AVE
Practice Address - Street 2:BLDG 500, SUITE 502
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7456
Practice Address - Country:US
Practice Address - Phone:860-575-1994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty