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General NPI Number Information
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NPI Number | 1114140324
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Entity Type | Organization
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Legal Business Name | RANJAN MAHAJAN, MD PLC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 150 CLEARWATER LARGO RD N SUITE 2
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City | LARGO
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State | FL
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Zip | 33770-2388
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Country | US
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Telephone | 727-518-0822
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Fax | 727-518-6511
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Provider Business Mailing Address
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Address Line | 150 CLEARWATER LARGO RD N SUITE 2
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City | LARGO
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State | FL
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Zip | 33770-2388
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Country | US
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Telephone | 727-518-0822
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Fax | 727-518-6511
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Authorized Official
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Title or Position | OWNER
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Name | DR. RANJAN MAHAJAN
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Credential | M.D.
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Telephone | 727-518-0822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | ME0069005
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License Number State | FL
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