Provider Demographics
NPI:1962496133
Name:KUMAR, RAKESH (MD)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:
Last Name:KUMAR
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 1:5106 N ARMENIA AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1433
Mailing Address - Country:US
Mailing Address - Phone:813-877-7463
Mailing Address - Fax:813-350-0626
Practice Address - Street 1:5106 N ARMENIA AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1433
Practice Address - Country:US
Practice Address - Phone:813-877-7463
Practice Address - Fax:813-350-0626
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78263207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271791OtherAVMED
FL49778OtherBLUE CROSS BLUE SHIELD
FLH7941585001OtherCIGNA
FL271791OtherAVMED
H07289Medicare UPIN