Provider Demographics
NPI:1457378002
Name:RAJ K PAI MD PA
Entity Type:Organization
Organization Name:RAJ K PAI MD PA
Other - Org Name:CLEARWATER PEDIATRIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:KOCHIKAR
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-818-1543
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:33765-3310
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:33765-3310
Practice Address - Country:US
Practice Address - Phone:727-461-1543
Practice Address - Fax:727-449-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068119208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272094900Medicaid