Individual
DR. DANTULURI P RAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2840 SE 3RD CT STE 100, OCALA, FL 34471-0480
(352) 622-1777
(352) 622-1929
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
34166
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000462200
—
FL
05
—
039223500
—
FL
01
—
42139
BCBS
FL
01
—
JQ057
MEDICARE
FL
Enumeration date
06/16/2005
Last updated
08/27/2020
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