| Mohammad Taj LLC | |
|
1543 Kingsley Ave Ste 14 Orange Park FL 32073-4570 | |
| (904) 264-6977 | |
| (904) 269-0870 |
| Full Name | Mohammad Taj LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1543 Kingsley Ave Ste 14, Orange Park, Florida |
| Authorized Official Name and Position | Mohammad Taj (PRESIDENT) |
| Authorized Official Contact | 9042646977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammad Taj LLC 1543 Kingsley Ave Ste 14 Orange Park FL 32073-4570 Ph: (904) 264-6977 | Mohammad Taj LLC 1543 Kingsley Ave Ste 14 Orange Park FL 32073-4570 Ph: (904) 264-6977 |
| NPI Number | 1588205884 |
|---|---|
| Provider Enumeration Date | 10/08/2019 |
| Last Update Date | 10/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588205884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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