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General NPI Number Information
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NPI Number | 1760610091
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Entity Type | Individual
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Provider Name | FRESHTA JAGHORI MD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1001 MONTICELLO AVE STE 100
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City | NORFOLK
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State | VA
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Zip | 23510-2564
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Country | US
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Telephone | 757-346-5770
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Fax | 866-292-0928
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Provider Business Mailing Address
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Address Line | 1231 N TUTTLE AVE
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City | SARASOTA
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State | FL
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Zip | 34237-3116
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Country | US
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Telephone | 941-366-0134
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Fax |
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 22847
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4852
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 300031
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101251757
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License Number State | VA
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