Provider Demographics
NPI:1255658548
Name:RAJPARA, RAJ SURESH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJ
Middle Name:SURESH
Last Name:RAJPARA
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 1:6400 SANGER RD STE A1000
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7400
Mailing Address - Country:US
Mailing Address - Phone:689-216-8190
Mailing Address - Fax:689-216-8193
Practice Address - Street 1:6400 SANGER RD STE A1000
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7400
Practice Address - Country:US
Practice Address - Phone:689-216-8190
Practice Address - Fax:689-216-8193
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2801702085R0001X
390200000X
FLME1293252085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCZDNF6OtherBCBS
FL020750000Medicaid
FL5639753OtherAETNA
FLQMP000005325445OtherMOLINA HEALTHCARE
FL403801OtherAVMED