Provider Demographics
NPI:1053315648
Name:RAO, RAJU V (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJU
Middle Name:V
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:14529 CORTEZ BLVD
Practice Address - Street 2:FLORIDA CANCER SPECIALISTS P L
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6065
Practice Address - Country:US
Practice Address - Phone:352-596-1401
Practice Address - Fax:352-597-2337
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2022-08-16
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Provider Licenses
StateLicense IDTaxonomies
FL125729207RH0000X, 207RX0202X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
202786OtherAVMED
FL371694500Medicaid
FL830001637OtherRR MEDICARE
FL18201OtherBC/BS FL
FL2503555OtherGHI
FL4577365OtherAETNA
0579213-001OtherCIGNA
FL18201ZOtherMEDICARE
F08014Medicare UPIN
FL0299820001Medicare NSC
0579213-001OtherCIGNA