Provider Demographics
NPI:1558819318
Name:AMRE, RAMILA (MD)
Entity Type:Individual
Prefix:
First Name:RAMILA
Middle Name:
Last Name:AMRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAMILA
Other - Middle Name:RADHAKRISHNA
Other - Last Name:MENON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-6865
Mailing Address - Country:US
Mailing Address - Phone:912-261-2669
Mailing Address - Fax:912-261-0561
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8202
Practice Address - Country:US
Practice Address - Phone:912-261-2669
Practice Address - Fax:912-261-0561
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128293207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology