Basic Information
| Provider Information | |||||||||
| NPI: | 1487616017 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAIKER | ||||||||
| FirstName: | ANILKUMAR | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6499 38TH AVE N | ||||||||
| Address2: | SUITE G1 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337101656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273813761 | ||||||||
| FaxNumber: | 7273479348 | ||||||||
| Practice Location | |||||||||
| Address1: | 6499 38TH AVE N | ||||||||
| Address2: | SUITE G1 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337101656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273813761 | ||||||||
| FaxNumber: | 7273479348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2006 | ||||||||
| LastUpdateDate: | 02/20/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | ME0051314 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 055511800 | 05 | FL | MEDICAID |