Provider Demographics
NPI:1194721662
Name:GERAMI, SOHRAB (MD)
Entity type:Individual
Prefix:
First Name:SOHRAB
Middle Name:
Last Name:GERAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 N ORANGE AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5501
Mailing Address - Country:US
Mailing Address - Phone:407-896-7111
Mailing Address - Fax:407-894-4018
Practice Address - Street 1:2320 N ORANGE AVE
Practice Address - Street 2:STE 201
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5501
Practice Address - Country:US
Practice Address - Phone:407-896-7111
Practice Address - Fax:407-894-4018
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME17968174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD55395Medicare UPIN
FL48683ZMedicare ID - Type Unspecified