Healthcare Provider Details

I. General information

NPI: 1477127066
Provider Name (Legal Business Name): HARRY RAMSAMOOJ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 BENMORE DR STE 201
WINTER PARK FL
32792-4111
US

IV. Provider business mailing address

133 BENMORE DR STE 201
WINTER PARK FL
32792-4111
US

V. Phone/Fax

Practice location:
  • Phone: 407-646-7070
  • Fax:
Mailing address:
  • Phone: 407-646-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME164055
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: