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General NPI Number Information
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NPI Number | 1861046211
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Entity Type | Organization
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Legal Business Name | SAND LAKE INTERNAL MEDICINE, LLC
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 7300 SANDLAKE COMMONS BLVD STE 221
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City | ORLANDO
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State | FL
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Zip | 32819-8011
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Country | US
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Telephone | 407-284-3552
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Fax | 407-284-3553
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Provider Business Mailing Address
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Address Line | 7300 SANDLAKE COMMONS BLVD STE 221
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City | ORLANDO
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State | FL
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Zip | 32819-8011
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Country | US
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Telephone | 407-284-3552
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Fax | 407-284-3553
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAJINDER SAHI
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Credential | MD
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Telephone | 407-284-3552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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