Provider Demographics
NPI:1376723205
Name:RAJPAL, CHITRA V (MBBS,MD)
Entity Type:Individual
Prefix:DR
First Name:CHITRA
Middle Name:V
Last Name:RAJPAL
Suffix:
Gender:F
Credentials:MBBS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:10131 SAN JOSE BLVD STE 24
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5857
Practice Address - Country:US
Practice Address - Phone:904-337-2055
Practice Address - Fax:904-337-2056
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008695000Medicaid
FLMC684OtherMEDICARE
FL14J86OtherBCBS