Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | ME63971 | FL |
NPI | 1326264177 |
---|---|
Provider Name | Dr. Radhakrishna K. Rao |
First Address | Tampa, FL 33607-6380 |
Second Address | Tampa, FL 33607-6380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 29/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
375370100 | (05) | FL |
F87011 | (02) |