Provider Demographics
NPI:1376965525
Name:RAJKUMAR, NALITA D (PA)
Entity Type:Individual
Prefix:MS
First Name:NALITA
Middle Name:D
Last Name:RAJKUMAR
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:222 BROADWAY UNIT 301
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5767
Mailing Address - Country:US
Mailing Address - Phone:407-846-8180
Mailing Address - Fax:407-347-4858
Practice Address - Street 1:222 BROADWAY
Practice Address - Street 2:SUITE 301
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5781
Practice Address - Country:US
Practice Address - Phone:407-846-8180
Practice Address - Fax:407-347-4857
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2014-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9107639363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant