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JAI HO NPI 1609321454


NPI Information

NPI: 1609321454
Provider Name: JAI HO

Doing Business As: SAND LAKE MEDICAL WALK IN CLINIC

Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 10D2119003

Address:
1650 SAND LAKE RD
SUITE 112A
ORLANDO, FL
ZIP 32809
Phone: (321) 289-1951
Get Directions

JAI HO is an addiction medicine internal medicine in Orlando, FL. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. JAI HO NPI is 1609321454. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sand Lake Medical Walk In Clinic.

The provider's business location address is:

1650 SAND LAKE RD
SUITE 112A
ORLANDO, FL
ZIP 32809-681
Phone: (321) 289-1951

The provider's authorized official is Kantilal Bhalani .
The authorized official title is Physicia and has the following contact phone number (407) 286-1829.

The CLIA number assigned to this NPI record is 10D2119003 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2016 and was last updated on 4/30/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3207RA0401XInternal MedicineAddiction MedicineME39710FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1016834700MEDICAIDFLORIDA
21609321454OTHERFLORIDANPI NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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