Provider Demographics
NPI:1386240935
Name:NAGLE, RAJESH ANIL
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:ANIL
Last Name:NAGLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8672 WARWICK SHORE XING
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8024
Mailing Address - Country:US
Mailing Address - Phone:407-446-4000
Mailing Address - Fax:
Practice Address - Street 1:9306 NARCOOSSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-5769
Practice Address - Country:US
Practice Address - Phone:407-438-6898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist