Provider Demographics
NPI:1114980067
Name:KARUNAKARA, RAJ GOPAL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJ
Middle Name:GOPAL
Last Name:KARUNAKARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1834 SW 1ST AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8101
Mailing Address - Country:US
Mailing Address - Phone:352-732-5552
Mailing Address - Fax:352-732-1131
Practice Address - Street 1:1834 SW 1ST AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-8101
Practice Address - Country:US
Practice Address - Phone:352-732-5552
Practice Address - Fax:352-732-1131
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME87174207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267102600Medicaid
FL267102600Medicaid
FLH93671Medicare UPIN