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General NPI Number Information
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NPI Number | 1205240983
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Entity Type | Organization
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Legal Business Name | RAMIAH KRISHNAN
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 06/20/2014
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Provider Practice Location Address
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Address Line | 126 DEL PRADO BLVD N SUIT 102
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City | CAPE CORAL
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State | FL
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Zip | 33909-2713
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Country | US
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Telephone | 239-772-8900
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Fax | 239-772-4219
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Provider Business Mailing Address
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Address Line | 126 DEL PRADO BLVD N SUIT 102
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City | CAPE CORAL
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State | FL
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Zip | 33909-2713
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Country | US
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Telephone | 239-772-8900
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Fax | 239-772-4219
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Authorized Official
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Title or Position | MANAGER
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Name | PATTY LAUX
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Credential |
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Telephone | 239-772-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0054933
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License Number State | FL
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