Basic Information
Provider Information
NPI: 1952540114
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PILLAI
FirstName: VIJAYAN
MiddleName: V
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7901 KINGSPOINTE PKWY
Address2: STE 1
City: ORLANDO
State: FL
PostalCode: 328196520
CountryCode: US
TelephoneNumber: 4072402361
FaxNumber: 4073458895
Practice Location
Address1: 7901 KINGSPOINTE PKWY
Address2: SUITE 1
City: ORLANDO
State: FL
PostalCode: 328196520
CountryCode: US
TelephoneNumber: 4072402361
FaxNumber: 4073458895
Other Information
ProviderEnumerationDate: 02/11/2009
LastUpdateDate: 02/11/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME91116FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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