MEDICARE: PROMED ASSOCIATES LLC

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	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689210858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMED ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	7642 BLUE QUAIL LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5815
Country	:	US
Telephone Number	:	609-892-8752
Fax Number	:	407-386-7878

Provider Business Practice Location Address
First Line	:	7642 BLUE QUAIL LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5815
Country	:	US
Telephone Number	:	609-892-8752
Fax Number	:	407-386-7878

Authorized Official
Title or Position	:	PARTNER
Name	:	NARSIMHA RANGARAJ
Credential	:	MD
Telephone Number	:	609-892-8752

Provider Enumeration Date	:	11/22/2019
Last Update Date	:	11/22/2019

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Directions to “PROMED ASSOCIATES LLC ” Practice Location

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