Provider Demographics
NPI:1194799387
Name:SETH, RAGHAV LOVE (MD)
Entity type:Individual
Prefix:DR
First Name:RAGHAV
Middle Name:LOVE
Last Name:SETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2204
Mailing Address - Country:US
Mailing Address - Phone:954-616-5593
Mailing Address - Fax:954-368-2562
Practice Address - Street 1:7421 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2204
Practice Address - Country:US
Practice Address - Phone:954-616-5593
Practice Address - Fax:954-368-2562
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0052141207RC0000X
CAA 44071207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370251100Medicaid
D17087Medicare UPIN
FL370251100Medicaid