Healthcare Provider Details

I. General information

NPI: 1962775353
Provider Name (Legal Business Name): RALPH GARRAMONE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12998 S CLEVELAND AVE
FORT MYERS FL
33907-3849
US

IV. Provider business mailing address

12998 S CLEVELAND AVE
FORT MYERS FL
33907-3849
US

V. Phone/Fax

Practice location:
  • Phone: 239-482-1900
  • Fax: 239-437-0433
Mailing address:
  • Phone: 239-482-1900
  • Fax: 239-437-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME75131
License Number StateFL

VIII. Authorized Official

Name: DR. RALPH RONALD GARRAMONE
Title or Position: PRESIDENT
Credential: MD
Phone: 239-482-1900