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Organization

AZIZ JUNAGADHWALLA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AZIZ JUNAGADHWALLA MD (PRESIDENT)
(941) 484-0651
Entity
Organization

Contact information

Practice address
732 THE RIALTO, VENICE, FL 34285-3524
(941) 484-0651
(941) 484-0652
Mailing address
732 THE RIALTO, VENICE, FL 34285-3524
(941) 484-0651
(941) 484-0652

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME034635
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801969050
INDIVIDUAL NPI
FL
05
371283400
FL
Enumeration date
12/16/2010
Last updated
12/16/2010
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