Basic Information
| Provider Information | |||||||||
| NPI: | 1750326013 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOHAI | ||||||||
| FirstName: | LAURIAN | ||||||||
| MiddleName: | VIRGIL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8425 NORTHCLIFFE BLVD | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346061107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526886346 | ||||||||
| FaxNumber: | 3526889103 | ||||||||
| Practice Location | |||||||||
| Address1: | 8425 NORTHCLIFFE BLVD | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346061107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526886346 | ||||||||
| FaxNumber: | 3526889103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 09/26/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME73749 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 110166027 | 01 | FL | MEDICARE RAILROAD | OTHER |