Healthcare Provider Details

I. General information

NPI: 1770111221
Provider Name (Legal Business Name): MOHAMMAD UMAR RAJA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR STE 281
OCOEE FL
34761-3432
US

IV. Provider business mailing address

10000 W COLONIAL DR STE 281
OCOEE FL
34761-3432
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-3467
  • Fax: 407-253-2563
Mailing address:
  • Phone: 321-841-3467
  • Fax: 407-253-2563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number181237
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA12699300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number181237
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number181237
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: