Provider Demographics
NPI:1134595093
Name:ARTHRITIS CENTER OF ORLANDO PA
Entity type:Organization
Organization Name:ARTHRITIS CENTER OF ORLANDO PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIMESH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-757-0277
Mailing Address - Street 1:PO BOX 645
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-0645
Mailing Address - Country:US
Mailing Address - Phone:407-296-1540
Mailing Address - Fax:407-296-2549
Practice Address - Street 1:1550 CITRUS MEDICAL CT
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761
Practice Address - Country:US
Practice Address - Phone:407-757-0277
Practice Address - Fax:407-757-0271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114449207RR0500X
332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1215145636OtherNPI
FL007376600Medicaid
FLME114449OtherLISCENCE
FL1134595093OtherGROUP NPI