MEDICARE: DR. PRADIP B BAIJU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME90104	FL
2	207RI0011X	Interventional Cardiology Physician	ME90104	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P01009058	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	37969	OTHER	FL	BCBS OF FL PROV #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831192186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRADIP B BAIJU M.D.

Provider Business Mailing Address
First Line	:	PO BOX 948479
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32794-8479
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1277 N SEMORAN BLVD
Second Line	:	SUITE 101
City	:	ORLANDO
State	:	FL
Zip	:	32807-3569
Country	:	US
Telephone Number	:	407-730-8970
Fax Number	:	407-730-8971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/30/2012

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Directions to “ DR. PRADIP B BAIJU M.D.” Practice Location

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