Individual
DR. BERNADETTE C. ANTONYRAJAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 6TH AVE, DES MOINES, IA 50314-2613
(515) 247-3330
(515) 643-8839
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
ME113647
FL
208000000X
Pediatrics Physician
Primary
ME113647
FL
2080P0203X
Pediatric Critical Care Medicine Physician
MD-43932
IA
2080P0203X
Pediatric Critical Care Medicine Physician
ME113647
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006240200
—
FL
01
—
14LE6
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/27/2008
Last updated
01/15/2024
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