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General NPI Number Information
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NPI Number | 1073828026
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Entity Type | Organization
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Legal Business Name | K. RANJIT FERNANDO, M.D., P.A.
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Dates
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Enumeration Date | 08/15/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 3722 CENTRAL AVE SUITE 2
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City | FORT MYERS
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State | FL
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Zip | 33901-8247
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Country | US
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Telephone | 239-936-1920
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Fax | 239-936-0371
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Provider Business Mailing Address
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Address Line | 3722 CENTRAL AVE SUITE 2
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City | FORT MYERS
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State | FL
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Zip | 33901-8247
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Country | US
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Telephone | 239-936-1920
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Fax | 239-936-0371
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Authorized Official
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Title or Position | PRESIDENT
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Name | KALUGAMAGE RANJIT FERNANDO
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Credential | M.D.
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Telephone | 239-936-1920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME30595
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License Number State | FL
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