Provider Demographics
NPI:1982613154
Name:BALDWIN PARK FAMILY PRACTICE, P.A.
Entity type:Organization
Organization Name:BALDWIN PARK FAMILY PRACTICE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-898-4550
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:407-898-4550
Mailing Address - Fax:407-898-4842
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:407-898-4550
Practice Address - Fax:407-898-4842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty