Provider Demographics
NPI:1881694339
Name:RAO, KRISHNA (MD)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 SE 3RD CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0479
Mailing Address - Country:US
Mailing Address - Phone:352-629-5000
Mailing Address - Fax:352-629-3390
Practice Address - Street 1:2840 SE 3RD CT
Practice Address - Street 2:SUITE 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0479
Practice Address - Country:US
Practice Address - Phone:352-629-5000
Practice Address - Fax:352-629-3390
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0037042207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039591900Medicaid
FL039591900Medicaid
42143Medicare PIN