Individual
DR. VIJAYAKUMAR TANJAVUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
511 MEDICAL PLAZA DR STE 101, LEESBURG, FL 34748-7328
(352) 728-6808
(352) 728-1743
Mailing address
511 MEDICAL PLAZA DR STE 101, LEESBURG, FL 34748-7328
(352) 728-6808
(352) 728-1743
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
296652
LA
2086S0129X
Vascular Surgery Physician
324586
LA
2086S0129X
Vascular Surgery Physician
Primary
ME164506
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126260100
—
FL
01
—
296652
STATE LICENSE
NY
01
—
324586
STATE LICENSE
LA
Enumeration date
04/02/2013
Last updated
04/07/2025
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