Provider Demographics
NPI:1356331714
Name:SOLANKI, RAJENDRA
Entity Type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:
Last Name:SOLANKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 CAPITAL MEDICAL BLVD STE 109-C
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-8417
Mailing Address - Country:US
Mailing Address - Phone:850-877-0320
Mailing Address - Fax:850-942-0246
Practice Address - Street 1:2770 CAPITAL MEDICAL BLVD STE 109-C
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-8417
Practice Address - Country:US
Practice Address - Phone:484-332-2280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S10825207RC0000X
PAOS009782L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019000130003Medicaid
H38186Medicare UPIN
062450FJEMedicare ID - Type Unspecified