MEDICARE: DR. SHIRIN ESMAIL RAWJI DDS

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	1223G0001X	General Practice Dentistry	DN12685	FL

General Provider Information

NPI Number	:	1588871057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIRIN ESMAIL RAWJI DDS

Provider Business Mailing Address
First Line	:	2116 S ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-3037
Country	:	US
Telephone Number	:	407-426-9933
Fax Number	:	407-426-9032

Provider Business Practice Location Address
First Line	:	2116 S ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-3037
Country	:	US
Telephone Number	:	407-426-9933
Fax Number	:	407-426-9032

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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