Healthcare Provider Details

I. General information

NPI: 1992770085
Provider Name (Legal Business Name): RAMESH KUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 ZEAGLER DR
PALATKA FL
32177-3810
US

IV. Provider business mailing address

145 CONFEDERATE POINT ROAD
PALATKA FL
32177
US

V. Phone/Fax

Practice location:
  • Phone: 480-543-7004
  • Fax:
Mailing address:
  • Phone: 386-916-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME88010
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME88010
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: