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General NPI Number Information
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NPI Number | 1902091218
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Entity Type | Individual
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Provider Name | RESHMA L MAHTANI D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 1228 S PINE ISLAND RD STE 410
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City | PLANTATION
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State | FL
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Zip | 33324-4583
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Country | US
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Telephone | 954-837-1490
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Fax | 954-837-1188
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Provider Business Mailing Address
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Address Line | PO BOX 743144
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City | ATLANTA
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State | GA
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Zip | 30374-3144
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Country | US
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Telephone | 954-837-1490
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Fax | 954-837-1188
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | OS10191
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | OS10191
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License Number State | FL
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