Individual
DR. DEVARAJU KANMANIRAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 383-1024
(904) 244-8827
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-3660
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
255618
NY
2085R0202X
Diagnostic Radiology Physician
Primary
ME107975
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003159388A
—
GA
05
—
014508600
—
FL
Enumeration date
05/20/2008
Last updated
05/13/2015
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