Provider Demographics
NPI:1073851531
Name:RAJANI MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:RAJANI MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:VAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-328-4633
Mailing Address - Street 1:1840 MEASE DR
Mailing Address - Street 2:STE 401B
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6602
Mailing Address - Country:US
Mailing Address - Phone:727-328-4633
Mailing Address - Fax:727-726-0529
Practice Address - Street 1:1840 MEASE DR
Practice Address - Street 2:STE 401B
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6602
Practice Address - Country:US
Practice Address - Phone:727-328-4633
Practice Address - Fax:727-726-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008051300Medicaid