Provider Demographics
NPI:1447254800
Name:BAJAJ, SANDEEP (MD)
Entity type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:
Last Name:BAJAJ
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 1:483 N SEMORAN BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3800
Mailing Address - Country:US
Mailing Address - Phone:407-645-1847
Mailing Address - Fax:321-274-0246
Practice Address - Street 1:483 N SEMORAN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3800
Practice Address - Country:US
Practice Address - Phone:407-645-1847
Practice Address - Fax:321-274-0246
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64582207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2171130012OtherCIGNA PROV ID #
FL373499400Medicaid
FL12650OtherFHHS PROV ID #
FL196550OtherSTAYWELL MCD PROV ID #
FL196550OtherHEALTHESE MCD PROV ID #
FL208683OtherAMERIGROUP MCD PROV ID #
FL196550OtherWELLCARE PROV ID #
FL386222OtherHUMANA PROV ID #
FL1090291OtherUNITED H'CARE PROV ID #
FL23141OtherBCBS OF FL PROV ID #
FL060039486OtherRAILROAD MEDICARE
FL72852OtherFIRST HEALTH PROV ID #
FL273066OtherGREAT WEST PROV ID #
FL4411299OtherAETNA PRO ID
E62283Medicare UPIN
FL208683OtherAMERIGROUP MCD PROV ID #