Provider Demographics
NPI:1073828026
Name:K. RANJIT FERNANDO, M.D., P.A.
Entity Type:Organization
Organization Name:K. RANJIT FERNANDO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALUGAMAGE
Authorized Official - Middle Name:RANJIT
Authorized Official - Last Name:FERNANDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-936-1920
Mailing Address - Street 1:3722 CENTRAL AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-8247
Mailing Address - Country:US
Mailing Address - Phone:239-936-1920
Mailing Address - Fax:239-936-0371
Practice Address - Street 1:3722 CENTRAL AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-8247
Practice Address - Country:US
Practice Address - Phone:239-936-1920
Practice Address - Fax:239-936-0371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-15
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30595207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty