Provider Demographics
NPI:1508973900
Name:RAMNATH, RAVI R (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:R
Last Name:RAMNATH
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:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32902
Mailing Address - Country:US
Mailing Address - Phone:321-409-9990
Mailing Address - Fax:321-309-9033
Practice Address - Street 1:709 S HARBOR CITY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1968
Practice Address - Country:US
Practice Address - Phone:321-409-9990
Practice Address - Fax:321-309-9033
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME851812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2891992Medicaid
FLP00786987OtherRAILROAD MCR
PA1022534280001Medicaid
IA1508973900Medicaid
FL62766OtherBCBS
SCQ85181Medicaid
FL266617100Medicaid
SD7725590Medicaid
NH1508973900Medicaid
MI1508973900Medicaid
FL62766OtherBCBS
MI1508973900Medicaid
OH2891992Medicaid
FL627660Medicare PIN
FL62766NMedicare PIN