Provider Demographics
NPI:1659368934
Name:SAREEN, RAJAN (MD)
Entity Type:Individual
Prefix:
First Name:RAJAN
Middle Name:
Last Name:SAREEN
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:PO BOX 51108
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33994-1108
Mailing Address - Country:US
Mailing Address - Phone:239-694-2161
Mailing Address - Fax:239-694-4131
Practice Address - Street 1:4801 PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-3214
Practice Address - Country:US
Practice Address - Phone:239-694-2161
Practice Address - Fax:239-694-4131
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD84949Medicare UPIN