Healthcare Provider Details

I. General information

NPI: 1598741928
Provider Name (Legal Business Name): HEMANT PRABHUDAS PAINTER MD, MB.,BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7232 W SAND LAKE RD STE 102
ORLANDO FL
32819-5253
US

IV. Provider business mailing address

7232 W SAND LAKE RD SUITE 102
ORLANDO FL
32819-5260
US

V. Phone/Fax

Practice location:
  • Phone: 407-237-0900
  • Fax: 407-237-0901
Mailing address:
  • Phone: 407-237-0900
  • Fax: 407-237-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number25MA06926300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME0073298
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: