Provider Demographics
NPI:1902830839
Name:KALIA, RAJAN (MD)
Entity Type:Individual
Prefix:
First Name:RAJAN
Middle Name:
Last Name:KALIA
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; 691861
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869
Mailing Address - Country:US
Mailing Address - Phone:407-254-2500
Mailing Address - Fax:407-423-2789
Practice Address - Street 1:801 W OAK ST,
Practice Address - Street 2:STE# 203
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-284-1993
Practice Address - Fax:407-362-7136
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 93136207L00000X, 207LP2900X
FLME93136207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251915100OtherGTBA GROUP MEDICAID #
FL40929OtherGTBA GROUP MEDICARE #
FL40929OtherGTBA BCBS GROUP #
FL40929OtherGTBA GROUP MEDICARE #
U7798ZMedicare PIN