Premier Physicians Orlando LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PREMIER PHYSICIANS ORLANDO LLC

Practice address

331 N Maitland Ave Ste C1
Maitland, FL 32751-4754

Phone

(407) 644-2218

Fax

(407) 644-9260

NPI assigned

Oct 15, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sandeep Pandya, MDNPI 1023371796

Title

Ceo

Phone

(407) 644-2218

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandeep Pandya, MD

  • Family Medicine Physician
  • Maitland, FL
  • NPI 1023371796
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1215403464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 N MAITLAND AVE STE C1",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514754",
            "telephone_number": "407-644-2218",
            "fax_number": "407-644-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 N MAITLAND AVE STE C1",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514754",
            "telephone_number": "407-644-2218",
            "fax_number": "407-644-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIANS ORLANDO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "PANDYA",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-644-2218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allen Erskine Prince-Gamboa

• Family Medicine Physician in Maitland, FL
• Providers in Maitland, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.