Provider Demographics
NPI:1265719405
Name:SK RAMAN PA
Entity type:Organization
Organization Name:SK RAMAN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIVAKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-350-4757
Mailing Address - Street 1:3000 OASIS GRAND BLVD
Mailing Address - Street 2:# 1607
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-1524
Mailing Address - Country:US
Mailing Address - Phone:609-350-4757
Mailing Address - Fax:
Practice Address - Street 1:3000 OASIS GRAND BLVD
Practice Address - Street 2:# 1607
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-1524
Practice Address - Country:US
Practice Address - Phone:609-350-4757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100391207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty