Individual
KRISHNA PRIYA RAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16420 HEALTHPARK COMMONS DR, FORT MYERS, FL 33908-9621
(239) 985-1925
(239) 321-6044
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 985-1925
(239) 321-6044
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME90923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277153500
—
FL
01
—
304247
AVMED
FL
01
—
41818
BCBS
—
01
—
7124286
AETNA
FL
01
—
P01319836
RR MEDICARE
FL
01
—
P108782
FREEDOM
FL
01
—
P511755
OPTIMUM
FL
Enumeration date
05/11/2006
Last updated
08/20/2024
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