Provider Demographics
NPI:1215193859
Name:AMERI MINDCARE PA
Entity Type:Organization
Organization Name:AMERI MINDCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMARAO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKKENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-932-2799
Mailing Address - Street 1:3389 W VINE ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4665
Mailing Address - Country:US
Mailing Address - Phone:407-932-2799
Mailing Address - Fax:407-932-0303
Practice Address - Street 1:3389 W VINE ST
Practice Address - Street 2:SUITE 304
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4665
Practice Address - Country:US
Practice Address - Phone:407-932-2799
Practice Address - Fax:407-932-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME935202084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38008OtherBCBS
FL009151600Medicaid
FLH98122Medicare UPIN
FLU6809Medicare PIN