Provider Demographics
NPI:1477741429
Name:IRAJ HEALTHCARE INC
Entity Type:Organization
Organization Name:IRAJ HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-284-1993
Mailing Address - Street 1:801 W OAK ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6614
Mailing Address - Country:US
Mailing Address - Phone:407-284-1993
Mailing Address - Fax:407-362-7136
Practice Address - Street 1:801 W OAK ST
Practice Address - Street 2:SUITE 203
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6614
Practice Address - Country:US
Practice Address - Phone:407-284-1993
Practice Address - Fax:407-362-7136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93136208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME93136OtherMEDICAL LICENSE NUMBER