Provider Demographics
NPI:1891723672
Name:MAHARAJ, PRIYA (DO)
Entity Type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:
Last Name:MAHARAJ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 WOODCOCK RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3525
Mailing Address - Country:US
Mailing Address - Phone:407-697-8902
Mailing Address - Fax:
Practice Address - Street 1:1040 WOODCOCK RD
Practice Address - Street 2:STE. 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3525
Practice Address - Country:US
Practice Address - Phone:407-697-8902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI63586Medicare UPIN