Healthcare Provider Details

I. General information

NPI: 1770857260
Provider Name (Legal Business Name): MEYYAPPAN RAMANATHAN R. PH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 W COLONIAL DR
OCOEE FL
34761-2946
US

IV. Provider business mailing address

7224 LONDALE BLVD
WINDERMERE FL
34786-6303
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-6910
  • Fax: 407-877-6912
Mailing address:
  • Phone: 570-341-5728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS43250
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: