Provider Demographics
NPI:1316301070
Name:RAJYAGURU, NEAL VRAJLAL (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:VRAJLAL
Last Name:RAJYAGURU
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 1:505 W VINE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4123
Mailing Address - Country:US
Mailing Address - Phone:407-934-9404
Mailing Address - Fax:
Practice Address - Street 1:505 W VINE ST STE 301
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4123
Practice Address - Country:US
Practice Address - Phone:407-935-9404
Practice Address - Fax:407-935-9304
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144874208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation