Healthcare Provider Details

I. General information

NPI: 1932832995
Provider Name (Legal Business Name): VICTORIA VIRGINIA DAJANI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PALM AVE STE 500
JACKSONVILLE FL
32207-8457
US

IV. Provider business mailing address

1301 PALM AVE STE 500
JACKSONVILLE FL
32207-8457
US

V. Phone/Fax

Practice location:
  • Phone: 904-202-7300
  • Fax:
Mailing address:
  • Phone: 904-202-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: