Healthcare Provider Details

I. General information

NPI: 1649206020
Provider Name (Legal Business Name): MILAN JANMEJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 W GORE ST STE 101
ORLANDO FL
32806-1124
US

IV. Provider business mailing address

70 W GORE ST STE 101
ORLANDO FL
32806-1124
US

V. Phone/Fax

Practice location:
  • Phone: 321-842-3765
  • Fax: 321-842-3787
Mailing address:
  • Phone: 321-842-3765
  • Fax: 321-842-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number047459
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME110890
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME110890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: