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NPI Code Detail

MEDICARE: SHIVA TAJIANI PA-C

MEDICARE: SHIVA TAJIANI PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA9116917FL
2363AS0400XSurgical Physician AssistantPA9116917FL
3363A00000XPhysician AssistantPA9116917FL

General Provider Information

NPI Number : 1417729252
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIVA TAJIANI PA-C
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line :
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 392-274-8200
Fax Number :
Provider Business Practice Location Address
First Line : 40215 HIGHWAY 27
Second Line :
City : DAVENPORT
State : FL
Zip : 33837-7813
Country : US
Telephone Number : 863-421-9705
Fax Number : 863-421-9779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2023
Last Update Date : 02/20/2025

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Directions to “ SHIVA TAJIANI PA-C” Practice Location

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