Healthcare Provider Details

I. General information

NPI: 1194474577
Provider Name (Legal Business Name): ABHINAV RAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W HIGHLAND BLVD
INVERNESS FL
34452-4720
US

IV. Provider business mailing address

17 AARON CT
BRIDGEWATER NJ
08807-5681
US

V. Phone/Fax

Practice location:
  • Phone: 352-726-1551
  • Fax:
Mailing address:
  • Phone: 908-255-8757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number88279
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number178613
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1111111111
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: