Provider Demographics
NPI:1265519052
Name:HIPPALGAONKAR, RAJENDRA GOVIND (MD)
Entity type:Individual
Prefix:DR
First Name:RAJENDRA
Middle Name:GOVIND
Last Name:HIPPALGAONKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:932 SAXON BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8258
Mailing Address - Country:US
Mailing Address - Phone:386-774-2100
Mailing Address - Fax:386-774-0326
Practice Address - Street 1:932 SAXON BLVD
Practice Address - Street 2:STE A
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8258
Practice Address - Country:US
Practice Address - Phone:386-774-2100
Practice Address - Fax:386-774-0326
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME46947207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05944YMedicare ID - Type Unspecified