Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 125729 | FL |
Y | 207RX0202X | Medical Oncology | 125729 | FL |
NPI | 1053315648 |
---|---|
Provider Name | Dr. Raju V Rao |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Brooksville, FL 34613-6065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0579213-001 | CIGNA (01) | |
18201 | BC/BS FL (01) | FL |
18201Z | MEDICARE (01) | FL |
202786 | AVMED (01) | |
2503555 | GHI (01) | FL |
371694500 | (05) | FL |
4577365 | AETNA (01) | FL |
830001637 | RR MEDICARE (01) | FL |
F08014 | (02) |