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General NPI Number Information
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NPI Number | 1215120639
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Entity Type | Organization
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Legal Business Name | SUJATHA RAMAMURTHY MD PA
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 15200 JOG RD SUITE 303
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City | DELRAY BEACH
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State | FL
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Zip | 33446-1247
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Country | US
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Telephone | 561-637-3612
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Fax | 561-637-6750
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Provider Business Mailing Address
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Address Line | PO BOX 970386
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City | BOCA RATON
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State | FL
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Zip | 33497-0386
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Country | US
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Telephone | 561-637-3612
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Fax | 561-637-6750
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Authorized Official
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Title or Position | OWNER
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Name | SUJATHA RAMAMURTHY
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Credential | MD
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Telephone | 561-637-3612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME84067
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License Number State | FL
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