Provider Demographics
NPI:1407870132
Name:PARIKH, AJAY MAHESHCHANDRA (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:AJAY
Middle Name:MAHESHCHANDRA
Last Name:PARIKH
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 DEERVIEW PL
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1670 PROVIDENCE BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-4961
Practice Address - Country:US
Practice Address - Phone:386-574-7122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265868200Medicaid
42251Medicare ID - Type Unspecified
FL265868200Medicaid