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General NPI Number Information
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NPI Number | 1528172731
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Entity Type | Organization
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Legal Business Name | ORLANDO PSYCHIATRIC ASSOCIATES INC.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 2345 SAND LAKE RD SUITE 200
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City | ORLANDO
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State | FL
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Zip | 32809-9142
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Country | US
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Telephone | 407-851-5121
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Fax | 407-851-0439
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Provider Business Mailing Address
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Address Line | PO BOX 714
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City | WINDERMERE
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State | FL
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Zip | 34786-0714
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Country | US
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Telephone | 407-851-5121
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Fax | 407-851-0439
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BHASKAR NANDIMANDALAM RAJU
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Credential | M.D.
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Telephone | 407-851-5121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME91130
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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