Provider Demographics
NPI:1124267455
Name:RAJADORAI CALNAIDO MD PA
Entity type:Organization
Organization Name:RAJADORAI CALNAIDO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ELOISE
Authorized Official - Last Name:REAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-226-6546
Mailing Address - Street 1:6680 HIGHWAY 87 N
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-6426
Mailing Address - Country:US
Mailing Address - Phone:850-626-2971
Mailing Address - Fax:
Practice Address - Street 1:6680 HIGHWAY 87 N
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-6426
Practice Address - Country:US
Practice Address - Phone:850-626-2971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27299261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1750365425OtherSOLE PROPRIETOR