RS Puri MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME28211 Issued in FL

Legal business name

RS PURI MD PA

Practice address

4120 US Highway 98 N Ste 400
Lakeland, FL 33809-3882

Phone

(863) 858-7878

Fax

(863) 853-7808

NPI assigned

Nov 7, 2012

Last updated

Nov 7, 2012By 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. Rajinder Singh Puri, M.D.

Title

President

Phone

(863) 858-7878

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1922352335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 US HIGHWAY 98 N STE 400",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093882",
            "telephone_number": "863-858-7878",
            "fax_number": "863-853-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 US HIGHWAY 98 N STE 400",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093882",
            "telephone_number": "863-858-7878",
            "fax_number": "863-853-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RS PURI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "PURI",
        "authorized_official_first_name": "RAJINDER",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-858-7878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME28211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058621800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.