Doctor Name: | VIJAYALAKSHMI RAJENDRAN |
NPI Number: | 1326063041 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | ME0050181 |
Business Practice Address: | 1500 Lakeland Hills Blvd Suite #2 Lakeland, FL - 338053257 |
Business Phone Number: | 8636828200 |
Business Fax Number: | 8636874161 |
Mailing Address: | 1500 Lakeland Hills Blvd, Suite #2 LAKELAND |
State: | FL |
Postal Code: | 338053257 |
Phone Number: | 8636828200 |
Fax Number: | 8636874161 |
NPI Enumeration Date: | 07/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME0050181 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |