MEDICARE: AADITYA JAGADISH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1497558589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AADITYA JAGADISH

Provider Business Mailing Address
First Line	:	3003 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6307
Country	:	US
Telephone Number	:	813-554-8126
Fax Number	:

Provider Business Practice Location Address
First Line	:	3003 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6307
Country	:	US
Telephone Number	:	813-554-8126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2025
Last Update Date	:	05/24/2026

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