Provider Demographics
NPI:1376832352
Name:SOMJI, ALYAZ A (DO)
Entity Type:Individual
Prefix:
First Name:ALYAZ
Middle Name:A
Last Name:SOMJI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7975 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8202
Mailing Address - Country:US
Mailing Address - Phone:407-303-6830
Mailing Address - Fax:407-303-8659
Practice Address - Street 1:7975 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8202
Practice Address - Country:US
Practice Address - Phone:407-303-6830
Practice Address - Fax:407-303-8659
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12149208M00000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program