MEDICARE: DR. RAKHEE MADAN WARD D.O.

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	2084P0804X	Child & Adolescent Psychiatry Physician	DOS-1098	HI
2	251S00000X	Community/Behavioral Health Agency	239772	MA
3	2084P0804X	Child & Adolescent Psychiatry Physician	OS11029	FL

General Provider Information

NPI Number	:	1881632693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAKHEE MADAN WARD D.O.

Provider Business Mailing Address
First Line	:	2479 ALOMA AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-2541
Country	:	US
Telephone Number	:	407-657-6692
Fax Number	:	407-894-6010

Provider Business Practice Location Address
First Line	:	2479 ALOMA AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-2541
Country	:	US
Telephone Number	:	407-657-6692
Fax Number	:	407-894-6010

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	11/04/2013

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