Provider Demographics
NPI:1023413143
Name:JAGANI, ALIASGHAR MEHEBOOB (OD)
Entity type:Individual
Prefix:DR
First Name:ALIASGHAR
Middle Name:MEHEBOOB
Last Name:JAGANI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 NEW BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6629
Mailing Address - Country:US
Mailing Address - Phone:407-979-4829
Mailing Address - Fax:407-369-4250
Practice Address - Street 1:4829 NEW BROAD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6629
Practice Address - Country:US
Practice Address - Phone:407-979-4829
Practice Address - Fax:407-369-4250
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist