Provider Demographics
NPI:1972625150
Name:FLORIDA HEALTH CARE OF ORLANDO PA
Entity type:Organization
Organization Name:FLORIDA HEALTH CARE OF ORLANDO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-229-5564
Mailing Address - Street 1:PO BOX 2157
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-2157
Mailing Address - Country:US
Mailing Address - Phone:321-229-5564
Mailing Address - Fax:407-901-3623
Practice Address - Street 1:6735 CONROY RD
Practice Address - Street 2:SUITE 223
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3565
Practice Address - Country:US
Practice Address - Phone:321-229-5564
Practice Address - Fax:407-901-3623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL74999174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255388100Medicaid
FL255388100Medicaid