DR. RAJIVI POTHIRAJ RUCKER M.D.
Allergy and Immunology
Sarasota, Florida
Provider NPI: 1194721522
Provider Information:DR. RAJIVI POTHIRAJ RUCKER M.D.
Practice Location:
1250 S TAMIAMI TRL STE 302 SARASOTA, FL 34239 US
Tel: 941-877-5983 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 208000000X | Physicians Pediatrics | FL | ME84160 |
| Y | 207K00000X | Physicians Allergy & Immunology | FL | ME84160 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| FL BLUE | 48958 | FL | 01 |
| MEDICARE | KI170 | FL | 01 |
| 004579100 | FL | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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