Provider Demographics
NPI:1518172279
Name:JANARDHAN, AJIT HALDIPUR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:AJIT
Middle Name:HALDIPUR
Last Name:JANARDHAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 CENTURY MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2141
Mailing Address - Country:US
Mailing Address - Phone:321-265-4629
Mailing Address - Fax:850-682-6302
Practice Address - Street 1:860 CENTURY MEDICAL DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2141
Practice Address - Country:US
Practice Address - Phone:321-268-6111
Practice Address - Fax:386-263-2996
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122917207RC0001X, 207RC0001X
CO52814207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology