Individual
RAJU PRADHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9981 S HEALTHPARK DR, FORT MYERS, FL 33908-3618
(239) 343-2052
(239) 343-5348
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-2052
(239) 343-5348
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT189955
PA
208M00000X
Hospitalist Physician
Primary
ME122800
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014619800
—
FL
Enumeration date
03/02/2009
Last updated
03/29/2021
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