Suresh Raja MD LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SURESH RAJA MD LLC

Practice address

11104 Green Bayberry Dr
Palm Beach Gardens, FL 33418-1510

Phone

(561) 767-0721

NPI assigned

Apr 16, 2020

Last updated

Aug 28, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Suresh Rajamanickam, MD

Title

Direct Owner

Phone

(561) 767-0721

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1104446467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 GREEN BAYBERRY DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334181510",
            "telephone_number": "561-767-0721",
            "fax_number": "561-429-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 GREEN BAYBERRY DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334181510",
            "telephone_number": "561-767-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESH RAJA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "RAJAMANICKAM",
        "authorized_official_first_name": "SURESH",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "561-767-0721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ranee Sumner-Brooks, APRN
• Sun Group Partners LLC
• Sunset House, Inc
• Mallory Sunstrom
• Vanaja Sureddi, MD
• Surgcenter of Palm Beach Gardens
• Surgicath LLC
• Chrissi Suttman, CPLD, CPPD
• Madysen Swafford
• Aric J Swancutt

• Specialist in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.