MEDICARE: DR. RAVI NAGARAJAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME72472	FL

General Provider Information

NPI Number	:	1124004973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVI NAGARAJAN M.D.

Provider Business Mailing Address
First Line	:	1900 N ATLANTIC AVE UNIT 1602
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32118-8312
Country	:	US
Telephone Number	:	407-360-1742
Fax Number	:	321-339-1949

Provider Business Practice Location Address
First Line	:	1900 N ATLANTIC AVE UNIT 1602
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32118-8312
Country	:	US
Telephone Number	:	407-360-1742
Fax Number	:	321-339-1949

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	11/12/2024

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