Basic Information
Provider Information
NPI: 1154455665
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMCHARITAR
FirstName: COLETTE
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: PTA
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 4721 NW 115TH AVE
Address2:  
City: CORAL SPRINGS
State: FL
PostalCode: 330762154
CountryCode: US
TelephoneNumber: 9547532025
FaxNumber:  
Practice Location
Address1: 1830 NW 122ND TER
Address2:  
City: PEMBROKE PINES
State: FL
PostalCode: 330261966
CountryCode: US
TelephoneNumber: 9544355300
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/15/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000XPTA19279FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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