Provider Demographics
NPI:1972598779
Name:PAI, RAJENDRA KOCHIKAR (M D)
Entity Type:Individual
Prefix:DR
First Name:RAJENDRA
Middle Name:KOCHIKAR
Last Name:PAI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2370 DREW ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3318
Mailing Address - Country:US
Mailing Address - Phone:727-461-1543
Mailing Address - Fax:727-449-0594
Practice Address - Street 1:2370 DREW ST
Practice Address - Street 2:UNIT B
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3318
Practice Address - Country:US
Practice Address - Phone:727-461-1543
Practice Address - Fax:727-449-0594
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-18
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0068119208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377583600Medicaid
FL26767Medicare ID - Type UnspecifiedMEDICARE ID
FL377583600Medicaid