Healthcare Provider Details
I. General information
NPI: 1750383980
Provider Name (Legal Business Name): RAKESH ROHATGI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/01/2005
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 N US HIGHWAY 441 STE 540
THE VILLAGES FL
32159-8987
US
IV. Provider business mailing address
PO BOX 102222
ATLANTA GA
30368-2222
US
V. Phone/Fax
- Phone: 352-753-9777
- Fax: 866-446-1888
- Phone: 239-274-8200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | ME66930 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | ME66930 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: