Provider Demographics
NPI:1659577849
Name:JANI, ASHOK KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:KUMAR
Last Name:JANI
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 1:2202 BODRICK CIR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-1228
Mailing Address - Country:US
Mailing Address - Phone:813-748-7272
Mailing Address - Fax:
Practice Address - Street 1:1783 S KINGS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-315-9896
Practice Address - Fax:813-662-4818
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90232208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278498000Medicaid
AJ647ZMedicare PIN