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General NPI Number Information
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NPI Number | 1417290065
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Entity Type | Individual
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Provider Name | VIJAYAKUMAR TANJAVUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2013
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 511 MEDICAL PLAZA DR STE 101
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City | LEESBURG
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State | FL
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Zip | 34748-7328
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Country | US
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Telephone | 352-728-6808
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Fax | 352-728-1743
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Provider Business Mailing Address
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Address Line | 511 MEDICAL PLAZA DR STE 101
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City | LEESBURG
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State | FL
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Zip | 34748-7328
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Country | US
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Telephone | 352-728-6808
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Fax | 352-728-1743
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 324586
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 296652
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME164506
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License Number State | FL
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