Healthcare Provider Details

I. General information

NPI: 1366958894
Provider Name (Legal Business Name): CHATURANI RANASINGHE, M.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2017
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 VETERANS PARK DR STE 304
NAPLES FL
34109-0446
US

IV. Provider business mailing address

802 8TH CT W
NAPLES FL
34108-1875
US

V. Phone/Fax

Practice location:
  • Phone: 239-234-2448
  • Fax: 239-351-2578
Mailing address:
  • Phone: 239-234-2448
  • Fax: 239-351-2578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License NumberME113162
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME113162
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHATURANI RANASINGHE
Title or Position: CEO
Credential: MD
Phone: 786-252-8026