Healthcare Provider Details

I. General information

NPI: 1619906260
Provider Name (Legal Business Name): ARUN P. RAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7614 JACQUE RD STE C
HUDSON FL
34667-7195
US

IV. Provider business mailing address

7614 JACQUE RD STE C
HUDSON FL
34667-7195
US

V. Phone/Fax

Practice location:
  • Phone: 423-408-7220
  • Fax: 423-408-7405
Mailing address:
  • Phone: 423-408-7220
  • Fax: 423-408-7405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35444
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35444
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number0101258460
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: