Healthcare Provider Details

I. General information

NPI: 1366405136
Provider Name (Legal Business Name): H. S. RAMESH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 CLYDE MORRIS BLVD STE 400
ORMOND BEACH FL
32174-8185
US

IV. Provider business mailing address

325 CLYDE MORRIS BLVD STE 400
ORMOND BEACH FL
32174-8185
US

V. Phone/Fax

Practice location:
  • Phone: 386-671-0600
  • Fax: 386-677-9710
Mailing address:
  • Phone: 386-671-0600
  • Fax: 386-677-9710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberWV17815
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME131188
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: