Provider Demographics
NPI:1114954476
Name:SIVASEKARAN, RATNASABAPATHY (MD)
Entity Type:Individual
Prefix:
First Name:RATNASABAPATHY
Middle Name:
Last Name:SIVASEKARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 SE 3RD COURT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471
Mailing Address - Country:US
Mailing Address - Phone:352-369-5300
Mailing Address - Fax:352-369-5309
Practice Address - Street 1:2845 SE 3RD COURT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-369-5300
Practice Address - Fax:352-369-5309
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90344207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270559100Medicaid
FLBCBSOther50206
FL270559100Medicaid
FLI15504Medicare UPIN
FLBCBSOther50206