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NPI Code Detail

MEDICARE: ADIKKAN OANTHAN RAJAGOPAL MD

MEDICARE: ADIKKAN OANTHAN RAJAGOPAL MD
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
1207L00000XAnesthesiology Physician4301036289MI
2207L00000XAnesthesiology PhysicianME29883FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2AD661ZOTHERFLGTBA MEDICARE REASSIGN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
396524OTHERFLBCBS
4B43873OTHERUPIN
55829419OTHERFLAETNA
6050G310140OTHERMIBCBS OF MI

General Provider Information

NPI Number : 1740251404
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADIKKAN OANTHAN RAJAGOPAL MD
Provider Business Mailing Address
First Line : 3949 EVANS AVE
Second Line : SUITE 102
City : FORT MYERS
State : FL
Zip : 33901-9335
Country : US
Telephone Number : 239-939-2622
Fax Number : 239-939-0151
Provider Business Practice Location Address
First Line : 3949 EVANS AVE
Second Line : SUITE 102
City : FORT MYERS
State : FL
Zip : 33901-9335
Country : US
Telephone Number : 239-939-2622
Fax Number : 239-939-0151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/19/2009

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Directions to “ ADIKKAN OANTHAN RAJAGOPAL MD” Practice Location

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