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Organization
TAJ LLC
Active
Organization
TAJ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A NAGRANI MD (MEDICAL DIRECTOR)
(386) 423-5500
Entity
Organization
Contact information
Practice address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 423-5500
(386) 409-9762
Mailing address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 423-5500
(386) 409-9762
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME48245
FL
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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