Healthcare Provider Details

I. General information

NPI: 1689981375
Provider Name (Legal Business Name): RAMZY G MEDAA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 IMMOKALEE ROAD
NAPLES FL
34110
US

IV. Provider business mailing address

5955 PONCE DE LEON BLVD
CORAL GABLES FL
33146
US

V. Phone/Fax

Practice location:
  • Phone: 239-213-0690
  • Fax: 239-552-4060
Mailing address:
  • Phone: 305-662-8668
  • Fax: 305-662-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberME114401
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: