Provider Demographics
NPI:1720018369
Name:RAJ, CINDY LUE (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:CINDY
Middle Name:LUE
Last Name:RAJ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW 12TH AVE
Mailing Address - Street 2:SUITE 1129
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1096
Mailing Address - Country:US
Mailing Address - Phone:305-585-8957
Mailing Address - Fax:305-585-5259
Practice Address - Street 1:1500 NW 12TH AVE
Practice Address - Street 2:SUITE 1129
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1096
Practice Address - Country:US
Practice Address - Phone:305-585-8957
Practice Address - Fax:305-585-5259
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9209228367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306141800Medicaid
FLG2454ZMedicare ID - Type Unspecified