Organization
V.P. NAGARAJAN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE R SLAVINSKI (OFFICE MANAGER)
(352) 592-7779
Entity
Organization
Contact information
Practice address
12202 CORTEZ BLVD, BROOKSVILLE, FL 34613-2630
(352) 592-7779
(352) 592-7677
Mailing address
12202 CORTEZ BLVD, BROOKSVILLE, FL 34613-2631
(352) 592-7779
(352) 592-7677
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME30767
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069305700
—
FL
01
—
26072
BC/BS FL
FL
01
—
340001288
RAIL ROAD MEDICARE
—
Enumeration date
01/29/2008
Last updated
05/24/2010
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