Provider Demographics
NPI:1952753568
Name:POTTIMUTYAPU, RAMYA (MD)
Entity type:Individual
Prefix:
First Name:RAMYA
Middle Name:
Last Name:POTTIMUTYAPU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 CLARK ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9270
Mailing Address - Country:US
Mailing Address - Phone:407-977-1135
Mailing Address - Fax:
Practice Address - Street 1:870 CLARK ST STE 1000
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9270
Practice Address - Country:US
Practice Address - Phone:407-977-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125066677208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics