Provider Demographics
NPI:1871722025
Name:JAYARAJ, MAHENDRAN (MD)
Entity type:Individual
Prefix:DR
First Name:MAHENDRAN
Middle Name:
Last Name:JAYARAJ
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 1:1335 SLIGH BLVD, STE 3
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:321-874-1902
Mailing Address - Fax:321-843-1752
Practice Address - Street 1:1335 SLIGH BLVD, STE 3
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:321-874-1902
Practice Address - Fax:321-843-1752
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME151482207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology