Provider Demographics
NPI:1447516802
Name:LOUNGANI, RAJIV (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:RAJIV
Middle Name:
Last Name:LOUNGANI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:RAJ
Other - Middle Name:
Other - Last Name:LOUNGANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:822 A1A N STE 310
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-8209
Mailing Address - Country:US
Mailing Address - Phone:904-473-4963
Mailing Address - Fax:507-244-9158
Practice Address - Street 1:822 A1A N STE 310
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-8209
Practice Address - Country:US
Practice Address - Phone:904-473-4963
Practice Address - Fax:850-724-4915
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC391272084P0800X
FLME1341762084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry