Provider Demographics
NPI:1225478670
Name:RAVAL, HEMANTKUMAR RAMANLAL (MD)
Entity Type:Individual
Prefix:DR
First Name:HEMANTKUMAR
Middle Name:RAMANLAL
Last Name:RAVAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1324 LAKELAND HILLS BLVD
Mailing Address - Street 2:ATTN: MEDICAL STAFF OFFICE
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2625 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-3860
Practice Address - Country:US
Practice Address - Phone:863-284-5941
Practice Address - Fax:863-284-5199
Is Sole Proprietor?:No
Enumeration Date:2013-06-30
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME124441207RC0200X, 207RP1001X
KYTP701207RP1001X
KY50457207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program