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NPI Code Detail

MEDICARE: DR. KAVITHA RAJARATHNAM M.D.

MEDICARE: DR. KAVITHA RAJARATHNAM 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
1208000000XPediatrics PhysicianME154915FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME154915OTHERFLMEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548518616
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAVITHA RAJARATHNAM M.D.
Provider Business Mailing Address
First Line : 110 S WOODLAND ST
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-3546
Country : US
Telephone Number : 407-905-8827
Fax Number : 321-221-9454
Provider Business Practice Location Address
First Line : 19108 E COLONIAL DR
Second Line :
City : ORLANDO
State : FL
Zip : 32820-3701
Country : US
Telephone Number : 407-905-8827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2012
Last Update Date : 02/11/2025

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