Provider Demographics
NPI:1013962299
Name:RAJANI, VAKESH (MD)
Entity Type:Individual
Prefix:DR
First Name:VAKESH
Middle Name:
Last Name:RAJANI
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 25636
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5636
Mailing Address - Country:US
Mailing Address - Phone:727-328-4633
Mailing Address - Fax:727-726-0529
Practice Address - Street 1:1840 MEASE DR
Practice Address - Street 2:SUITE 401B
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6602
Practice Address - Country:US
Practice Address - Phone:727-328-4633
Practice Address - Fax:727-726-0529
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 77964207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256473400Medicaid
FLP01192810OtherRAILROAD MEDICARE
FL110196722OtherRAILROAD MEDICARE NUMBER
FL46872YMedicare PIN
FL256473400Medicaid
FL46872XMedicare PIN