Provider Demographics
NPI:1316099906
Name:S. VIROJA PA
Entity type:Organization
Organization Name:S. VIROJA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGMOHAN
Authorized Official - Middle Name:NATHALAL
Authorized Official - Last Name:VIROJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:561-929-6903
Mailing Address - Street 1:9542 SHEPARD PL
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6420
Mailing Address - Country:US
Mailing Address - Phone:561-929-6903
Mailing Address - Fax:561-798-2775
Practice Address - Street 1:9542 SHEPARD PL
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6420
Practice Address - Country:US
Practice Address - Phone:561-929-6903
Practice Address - Fax:561-798-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272653000Medicaid
K8824Medicare PIN
I3306Medicare UPIN