Individual
RAJEEV PURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-5595
(321) 434-8777
(321) 434-1775
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD19998
ME
208600000X
Surgery Physician
Primary
ME154811
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113854400
—
FL
01
—
O5879
FL HF MA
FL
Enumeration date
05/16/2007
Last updated
08/29/2022
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