Provider Demographics
NPI:1629460266
Name:DR. V. RAMCHARAN P.A.
Entity Type:Organization
Organization Name:DR. V. RAMCHARAN P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VYASA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMCHARAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-599-1221
Mailing Address - Street 1:2081 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4104
Mailing Address - Country:US
Mailing Address - Phone:407-599-1221
Mailing Address - Fax:407-599-1220
Practice Address - Street 1:2081 DUNDEE DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4104
Practice Address - Country:US
Practice Address - Phone:407-599-1221
Practice Address - Fax:407-599-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN118691223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL071518200Medicaid