MEDICARE: DR. MUTHURAMALINGAM RAMMOHAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME109492	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME109492	OTHER	FL	FLORIDA MEDICAL BOARD

General Provider Information

NPI Number	:	1649457052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUTHURAMALINGAM RAMMOHAN MD

Provider Business Mailing Address
First Line	:	3342 NE 34TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6906
Country	:	US
Telephone Number	:	954-583-7267
Fax Number	:	954-583-0535

Provider Business Practice Location Address
First Line	:	3342 NE 34TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6906
Country	:	US
Telephone Number	:	954-583-7267
Fax Number	:	954-583-0535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	01/07/2015

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