Provider Demographics
NPI:1700395407
Name:MICHAEL AHUJA MD LLC
Entity Type:Organization
Organization Name:MICHAEL AHUJA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-846-4603
Mailing Address - Street 1:PO BOX 111329
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0123
Mailing Address - Country:US
Mailing Address - Phone:386-846-4603
Mailing Address - Fax:
Practice Address - Street 1:1730 NE PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-9999
Practice Address - Country:US
Practice Address - Phone:386-846-4603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126324208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty