Provider Demographics
NPI:1033413356
Name:SHARAJA OF MIAMI LLC
Entity Type:Organization
Organization Name:SHARAJA OF MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:APARNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAJADHYAKSHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-987-5140
Mailing Address - Street 1:2000 N BAYSHORE DR
Mailing Address - Street 2:APT 210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5108
Mailing Address - Country:US
Mailing Address - Phone:305-987-5140
Mailing Address - Fax:
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-666-6511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL105193170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105193OtherSTATE LICENSE