Individual
JAINA MORAR MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4651 VAN DYKE RD, LUTZ, FL 33558-4880
(813) 321-1786
(813) 321-1787
Mailing address
4651 VAN DYKE RD, LUTZ, FL 33558-4880
(813) 321-1786
(813) 321-1787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108621
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102439900
—
FL
Enumeration date
03/21/2015
Last updated
11/16/2020
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