Provider Demographics
NPI:1043276231
Name:DESHMUKH, ABHIJIT VINOD (MD)
Entity type:Individual
Prefix:
First Name:ABHIJIT
Middle Name:VINOD
Last Name:DESHMUKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 CITRUS TOWER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1943
Mailing Address - Country:US
Mailing Address - Phone:352-536-8791
Mailing Address - Fax:352-536-8793
Practice Address - Street 1:1361 CITRUS TOWER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1943
Practice Address - Country:US
Practice Address - Phone:352-536-8791
Practice Address - Fax:352-536-8793
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0565442085R0001X
FLME646832085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022731900Medicaid
FLBD126ROtherMEDICARE
FL022731900Medicaid
FL212616OtherAVMED
FL23424OtherBCBS
GA799344858AMedicaid
FLBD126UMedicare PIN
FL23424OtherBCBS
FLP00186801OtherMEDICARE RAILROAD
FL23424JMedicare PIN
FLBD126SMedicare PIN
GA799344858AMedicaid
FL212616OtherAVMED
FLF67385Medicare UPIN
FL022731900Medicaid
FL23424OMedicare PIN
FL23424KMedicare PIN