Healthcare Provider Details

I. General information

NPI: 1700078979
Provider Name (Legal Business Name): FALCON MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 METROWEST BLVD STE 104
ORLANDO FL
32835-7630
US

IV. Provider business mailing address

6000 METROWEST BLVD SUITE 104
ORLANDO FL
32835-7630
US

V. Phone/Fax

Practice location:
  • Phone: 407-365-3033
  • Fax: 407-365-3034
Mailing address:
  • Phone: 407-365-3033
  • Fax: 407-365-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME 102387
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME 102387
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAIVIR S RATHORE
Title or Position: OWNER
Credential:
Phone: 216-925-2499