Healthcare Provider Details

I. General information

NPI: 1235497298
Provider Name (Legal Business Name): MEMORIAL PHYSICIAN GROUP- CHRISTOPHER RAMSARAN, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 03/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12781 MIRAMAR PKWY STE 202
MIRAMAR FL
33027-2908
US

IV. Provider business mailing address

12781 MIRAMAR PKWY STE 202
MIRAMAR FL
33027-2908
US

V. Phone/Fax

Practice location:
  • Phone: 954-276-1330
  • Fax: 954-276-0250
Mailing address:
  • Phone: 954-276-1330
  • Fax: 954-276-0250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME105808
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME105808
License Number StateFL

VIII. Authorized Official

Name: DR. CHRISTOPHER GEORGE RAMSARAN
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 954-276-1330