Provider Demographics
NPI:1831372408
Name:RAM EYE CARE CENTER MD PA
Entity type:Organization
Organization Name:RAM EYE CARE CENTER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ETHIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMCHANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-365-2333
Mailing Address - Street 1:PO BOX 1739
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-1739
Mailing Address - Country:US
Mailing Address - Phone:352-365-2333
Mailing Address - Fax:352-365-2024
Practice Address - Street 1:1131 E NORTH BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5375
Practice Address - Country:US
Practice Address - Phone:352-365-2333
Practice Address - Fax:352-365-2024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075978207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43773OtherBLUE CROSS BLUE SHIELD
FL43773OtherBLUE CROSS BLUE SHIELD
FLG77455Medicare UPIN