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Shiva
Shiva
Tajiani
Physician assistant
Medical
Lakeland, United States
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Florida Board of Medicine
Board Name
BOARD OF MEDICINE
Full name
Shiva Tajiani
Job Title
Physician Assistant
Qualifications
Prescribing
License Number
PA9116917
License Status
Clear/Active
License Issue Date
03/01/2023
License Expiry Date
31/01/2026
Source Type
Professional Profile
Florida Health Care Practitioner Data Portal
Full name
Shiva Tajiani
Job Title
Physician Assistant
Location
Lakeland, FL, USA
LIC ID
21103
Current License Expiration Date
31/01/2026
Original Date
03/01/2023
Professional Rank Code
PA
Effective Date
15/08/2023
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
POLK
Practice Location Address Line 1
2000 E Edgewood Dr. Ste 112
Practice Location Address City
LAKELAND
Practice Location Address State
FL
Practice Location Address Zipcode
33803
Mode Code
Prescribing
Prescribing Indicator
N
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