Provider Demographics
NPI:1669474086
Name:RAMA-DEPADUA, PAMELA RAMOS (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:RAMOS
Last Name:RAMA-DEPADUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:R
Other - Last Name:RAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M D
Mailing Address - Street 1:PO BOX 43667
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-3667
Mailing Address - Country:US
Mailing Address - Phone:904-720-0799
Mailing Address - Fax:904-241-5942
Practice Address - Street 1:1361 13TH AVE S STE 270
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3258
Practice Address - Country:US
Practice Address - Phone:904-241-7147
Practice Address - Fax:904-241-5492
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70554207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251960700Medicaid
FL251960700Medicaid
FL31808UMedicare PIN
FL31808SMedicare PIN
FL060063636Medicare PIN