Basic Information
| Provider Information | |||||||||
| NPI: | 1265719405 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SK RAMAN PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 OASIS GRAND BLVD | ||||||||
| Address2: | # 1607 | ||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339161524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093504757 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3000 OASIS GRAND BLVD | ||||||||
| Address2: | # 1607 | ||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339161524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093504757 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2011 | ||||||||
| LastUpdateDate: | 11/15/2011 | ||||||||
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| AuthorizedOfficialLastName: | RAMAN | ||||||||
| AuthorizedOfficialFirstName: | SIVAKUMAR | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6093504757 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | ME100391 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.