Provider Demographics
NPI:1669462040
Name:RAJ, VIJAY (MD)
Entity type:Individual
Prefix:MR
First Name:VIJAY
Middle Name:
Last Name:RAJ
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 1:19873 MAGNOLIA SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-8803
Mailing Address - Country:US
Mailing Address - Phone:571-344-8084
Mailing Address - Fax:
Practice Address - Street 1:19873 MAGNOLIA SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-8803
Practice Address - Country:US
Practice Address - Phone:571-344-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035132207QA0505X
FLME128772208D00000X
FLME 128772208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine