Provider Demographics
NPI:1972676187
Name:RAMIAH REHABILITATION, INC
Entity Type:Organization
Organization Name:RAMIAH REHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASBAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-672-8547
Mailing Address - Street 1:115 E GRANADA BLVD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176-6680
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 E GRANADA BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176-6680
Practice Address - Country:US
Practice Address - Phone:386-672-8547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0700X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686712Medicare ID - Type Unspecified