Organization
RAJANI RAVINDRA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJANI K RAVINDRA MD (MD/OWNER)
(386) 755-3000
Entity
Organization
Contact information
Practice address
1740 W US HIGHWAY 90, SUITE 102, LAKE CITY, FL 32055-4718
(386) 755-3000
Mailing address
1740 W US HIGHWAY 90, SUITE 102, LAKE CITY, FL 32055-4718
(386) 755-3000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME40806
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067671300
—
FL
Enumeration date
12/19/2016
Last updated
12/19/2016
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