Provider Demographics
NPI: | 1144674607 |
---|---|
Name: | DOCTORS OF CLINICAL SPECIALTIES LLC |
Entity type: | Organization |
Organization Name: | DOCTORS OF CLINICAL SPECIALTIES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SANDEEP |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BAJAJ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 407-500-3627 |
Mailing Address - Street 1: | 483 N SEMORAN BLVD STE 210 |
Mailing Address - Street 2: | |
Mailing Address - City: | WINTER PARK |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32792-3800 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-500-3627 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 483 N SEMORAN BLVD STE 210 |
Practice Address - Street 2: | |
Practice Address - City: | WINTER PARK |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32792 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-500-3627 |
Practice Address - Fax: | 407-930-4353 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-04-20 |
Last Update Date: | 2021-02-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207LP2900X, 207ND0900X, 207RC0000X, 207RG0100X, 207RH0003X, 207RI0011X, 207RN0300X, 207T00000X, 2085R0202X, 2086S0129X, 208800000X, 208M00000X, 261QM1300X, 207RH0003X | ||
FL | 207XX0005X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
No | 207ND0900X | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology | Group - Multi-Specialty |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
No | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |