Provider Demographics
NPI:1861606717
Name:TEJANI, MOHAMEDTAKI ABDULAZIZ (MD)
Entity type:Individual
Prefix:
First Name:MOHAMEDTAKI
Middle Name:ABDULAZIZ
Last Name:TEJANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 689
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4648
Mailing Address - Country:US
Mailing Address - Phone:407-303-2024
Mailing Address - Fax:407-303-2038
Practice Address - Street 1:2501 N ORANGE AVE STE 689
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4648
Practice Address - Country:US
Practice Address - Phone:407-303-2024
Practice Address - Fax:407-303-2038
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPENDING207R00000X
NY003764207RH0003X
FLME139844207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology