Individual
DR. MARIE ANGELINE ANTONYRAJAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
303 N CLYDE BLVD, DAYTONA BEACH, FL 32114
(386) 425-4000
Mailing address
303 N CLYDE BLVD, DAYTONA BEACH, FL 32114-0532
(904) 697-5062
(386) 425-4000
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
ME120640
FL
208000000X
Pediatrics Physician
Primary
ME120640
FL
208M00000X
Hospitalist Physician
ME120640
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014412800
—
FL
Enumeration date
07/18/2011
Last updated
03/13/2025
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