Basic Information
| Provider Information | |||||||||
| NPI: | 1710925896 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICIANS HOSPITALIST PARTNERS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6350 WEST COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072811755 | ||||||||
| FaxNumber: | 4014826871 | ||||||||
| Practice Location | |||||||||
| Address1: | 6350 WEST COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072811755 | ||||||||
| FaxNumber: | 4014826871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 10/20/2014 | ||||||||
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| AuthorizedOfficialLastName: | VYAS | ||||||||
| AuthorizedOfficialFirstName: | NAYANA | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4074477105 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME77880 | FL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | ME46318 | FL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 270394700 | 05 | FL | MEDICAID |