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General NPI Number Information
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NPI Number | 1245305440
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Entity Type | Organization
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Legal Business Name | RADHARAJ, INC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 802 DUNLAWTON AVE SUITE 101
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City | PORT ORANGE
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State | FL
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Zip | 32127
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Country | US
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Telephone | 386-788-9086
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Fax | 386-788-6589
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Provider Business Mailing Address
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Address Line | 802 DUNLAWTON AVE SUITE 101
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City | PORT ORANGE
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State | FL
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Zip | 32127
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Country | US
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Telephone | 386-788-9086
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Fax | 386-788-6589
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BHADRESH I PATEL
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Credential | M.D.
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Telephone | 386-788-9086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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