Provider Demographics
NPI:1760470371
Name:NEBHRAJANI, RAJKUMAR METHARAM (MD)
Entity Type:Individual
Prefix:MR
First Name:RAJKUMAR
Middle Name:METHARAM
Last Name:NEBHRAJANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 WASHINGTON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8256
Mailing Address - Country:US
Mailing Address - Phone:954-322-7449
Mailing Address - Fax:954-322-7598
Practice Address - Street 1:3700 WASHINGTON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8256
Practice Address - Country:US
Practice Address - Phone:954-322-7449
Practice Address - Fax:954-322-7598
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064076208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G51814Medicare UPIN
FL262127Medicare ID - Type Unspecified