Healthcare Provider Details

I. General information

NPI: 1912044371
Provider Name (Legal Business Name): R A M MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 04/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 LUCERNE AVE
LAKE WORTH FL
33460-3821
US

IV. Provider business mailing address

604 LUCERNE AVE
LAKE WORTH FL
33460-3821
US

V. Phone/Fax

Practice location:
  • Phone: 561-586-8313
  • Fax: 561-586-8314
Mailing address:
  • Phone: 561-586-8313
  • Fax: 561-586-8314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO3175
License Number StateFL

VIII. Authorized Official

Name: DR. RANDHIR A LAL
Title or Position: D.P.M.
Credential: D.P.M.
Phone: 561-586-8313