Provider Demographics
NPI:1639376007
Name:MEHTA, AJAY JITENDRA (MD)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:JITENDRA
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3310 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7422
Mailing Address - Country:US
Mailing Address - Phone:352-873-0707
Mailing Address - Fax:352-873-9615
Practice Address - Street 1:3310 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7422
Practice Address - Country:US
Practice Address - Phone:352-873-0707
Practice Address - Fax:352-873-9615
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103107207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology