Provider Demographics
NPI:1699017863
Name:RAVIKANTH CHIRAVURI MD PA
Entity Type:Organization
Organization Name:RAVIKANTH CHIRAVURI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVIKANTH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRAVURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-702-9441
Mailing Address - Street 1:4420 SHERIDAN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3552
Mailing Address - Country:US
Mailing Address - Phone:305-396-3858
Mailing Address - Fax:305-514-0636
Practice Address - Street 1:4420 SHERIDAN ST
Practice Address - Street 2:SUITE C
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3552
Practice Address - Country:US
Practice Address - Phone:305-396-3858
Practice Address - Fax:305-514-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 84617207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty