Provider Demographics
NPI:1548367709
Name:RAJENDER SINGH LAMBA MD PA
Entity type:Organization
Organization Name:RAJENDER SINGH LAMBA MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJENDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-862-3591
Mailing Address - Street 1:13028 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6421
Mailing Address - Country:US
Mailing Address - Phone:727-862-3581
Mailing Address - Fax:727-863-7034
Practice Address - Street 1:13028 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6421
Practice Address - Country:US
Practice Address - Phone:727-862-3581
Practice Address - Fax:727-863-7034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38256OtherBCBS
K0114OtherMEDICARE