Provider Demographics
NPI:1457457541
Name:AMILINENI, RAM M (MD)
Entity Type:Individual
Prefix:
First Name:RAM
Middle Name:M
Last Name:AMILINENI
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 1:999 S VOLUSIA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-6564
Mailing Address - Country:US
Mailing Address - Phone:386-775-7001
Mailing Address - Fax:386-774-2561
Practice Address - Street 1:999 S VOLUSIA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-6564
Practice Address - Country:US
Practice Address - Phone:386-775-7001
Practice Address - Fax:386-774-2561
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine