Individual
JAWED PANJA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
875 STERTHAUS AVE, ORMOND BEACH, FL 32174-5131
(386) 676-0255
(386) 676-2555
Mailing address
22 DEEP WOODS WAY, ORMOND BEACH, FL 32174-1846
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME72018
FL
Other
Enumeration date
05/31/2006
Last updated
07/08/2007
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