Individual
AJAY HARENDRA BISHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18550 US HIGHWAY 441, STE A, MOUNT DORA, FL 32757-6751
(352) 735-3755
(352) 735-3151
Mailing address
10250 SE 167TH PLACE RD UNIT 5, SUMMERFIELD, FL 34491-8682
(352) 307-9925
(352) 307-8442
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME98575
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278772500
—
FL
Enumeration date
05/30/2007
Last updated
01/11/2018
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