Provider Demographics
NPI:1396914297
Name:RAO, PRIYADARSHINI GOPINATH (DO)
Entity type:Individual
Prefix:DR
First Name:PRIYADARSHINI
Middle Name:GOPINATH
Last Name:RAO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:GOPINATH
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:10707 66TH ST N
Mailing Address - Street 2:SUITE A
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-2352
Mailing Address - Country:US
Mailing Address - Phone:727-544-8300
Mailing Address - Fax:727-544-8366
Practice Address - Street 1:3600 OAK MANOR LN APT 46
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-1214
Practice Address - Country:US
Practice Address - Phone:727-489-3305
Practice Address - Fax:727-499-9559
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10302207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine