Provider Demographics
NPI:1598186959
Name:ANJANA RANA
Entity Type:Organization
Organization Name:ANJANA RANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-208-1200
Mailing Address - Street 1:609 5TH ST SW STE D
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-2216
Mailing Address - Country:US
Mailing Address - Phone:386-208-1200
Mailing Address - Fax:386-208-1300
Practice Address - Street 1:609 5TH ST SW STE D
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-2216
Practice Address - Country:US
Practice Address - Phone:386-208-1200
Practice Address - Fax:386-208-1300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANJANA RANA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty