Healthcare Provider Details

I. General information

NPI: 1386138733
Provider Name (Legal Business Name): HIFFSA SOHAIL TAJ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 E MAXWELL ST FL 3
LEXINGTON KY
40508-2640
US

IV. Provider business mailing address

6850 LAKE NONA BLVD
ORLANDO FL
32827-7408
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-5350
  • Fax: 859-323-7660
Mailing address:
  • Phone: 407-261-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number56511
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number56511
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: