Individual
DR. RAJANI K RAVINDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1740 W US HWY 90, STE 102, LAKE CITY, FL 32055
(386) 755-3000
(386) 719-4297
Mailing address
1740 W US HWY 90, STE 102, LAKE CITY, FL 32055
(386) 755-3000
(386) 719-4297
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME40806
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010023058
RAILROAD MEDICARE
—
01
—
088689
VALUE OPTIONS
—
01
—
12064
BCBS
—
01
—
237718
ARMED
—
Enumeration date
06/21/2006
Last updated
12/04/2009
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