Provider Demographics
NPI:1184716565
Name:THANGAVELU, RAJANI (MD)
Entity type:Individual
Prefix:DR
First Name:RAJANI
Middle Name:
Last Name:THANGAVELU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 HORSESHOE DR S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-6113
Mailing Address - Country:US
Mailing Address - Phone:239-659-9188
Mailing Address - Fax:
Practice Address - Street 1:2865, HORSESHOE DRIVE SOUTH
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104
Practice Address - Country:US
Practice Address - Phone:239-659-9188
Practice Address - Fax:239-659-0526
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-249122084F0202X
MI417252084P0800X
OH35-05-0199-T2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry