Provider Demographics
NPI:1750367041
Name:RAMSAY, MARIS GAIL (DO)
Entity type:Individual
Prefix:DR
First Name:MARIS
Middle Name:GAIL
Last Name:RAMSAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 N HIAWASSEE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-3008
Mailing Address - Country:US
Mailing Address - Phone:407-906-0082
Mailing Address - Fax:407-604-2606
Practice Address - Street 1:2724 N HIAWASSEE RD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3008
Practice Address - Country:US
Practice Address - Phone:407-906-0082
Practice Address - Fax:407-604-2606
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0004731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053517600Medicaid
D60696Medicare UPIN
82668Medicare ID - Type Unspecified