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NPI Code Detail

MEDICARE: DR. MORTEZA NADJAFI M.D.

MEDICARE: DR. MORTEZA NADJAFI M.D.
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
12084P0804XChild & Adolescent Psychiatry PhysicianME0027588FL
22084P0800XPsychiatry PhysicianME0027588FL

General Provider Information

NPI Number : 1912954660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MORTEZA NADJAFI M.D.
Provider Business Mailing Address
First Line : 736 N MAGNOLIA AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32803-3809
Country : US
Telephone Number : 407-423-7149
Fax Number : 407-422-0470
Provider Business Practice Location Address
First Line : 736 N MAGNOLIA AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32803-3809
Country : US
Telephone Number : 407-423-7149
Fax Number : 407-422-0470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 12/09/2013

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