Provider Demographics
NPI:1417993940
Name:RAO, CHRISTOPHER G (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:G
Last Name:RAO
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 1:6 FIELDWAY DR
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-6619
Mailing Address - Country:US
Mailing Address - Phone:772-475-3163
Mailing Address - Fax:772-877-0395
Practice Address - Street 1:515 N FLAGLER DR STE P300
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4326
Practice Address - Country:US
Practice Address - Phone:561-779-4558
Practice Address - Fax:772-877-0395
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064920207Q00000X
LAMD11942R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26776SOtherWELLMED MEDICAL MANAGEMENT OF FLORIDA INC
LA1684830Medicaid
FL26776YMedicare PIN
LA1684830Medicaid
LA5W9456629Medicare PIN