Provider Demographics
NPI:1184626574
Name:RAO, SAMEET K (MD)
Entity type:Individual
Prefix:DR
First Name:SAMEET
Middle Name:K
Last Name:RAO
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 1:1295 ROUTE 38
Mailing Address - Street 2:P.O. BOX 479
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2702
Mailing Address - Country:US
Mailing Address - Phone:609-261-7017
Mailing Address - Fax:609-261-4180
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-5600
Practice Address - Fax:317-705-5047
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY532652085R0202X
FLME957452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0068586Medicaid
NJ092030Medicare ID - Type Unspecified
NJ0068586Medicaid