Provider Demographics
NPI:1083876197
Name:RAJCA, BRIAN PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PHILIP
Last Name:RAJCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 DEL PRADO BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2667
Mailing Address - Country:US
Mailing Address - Phone:239-772-3636
Mailing Address - Fax:239-772-5073
Practice Address - Street 1:625 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2667
Practice Address - Country:US
Practice Address - Phone:239-772-3636
Practice Address - Fax:239-772-5073
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 106197207R00000X
WI61620-20207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology