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General NPI Number Information
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NPI Number | 1285820555
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Entity Type | Individual
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Provider Name | ANITA RAVI M.D
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Gender | Female
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 1615 PASADENA AVE S STE 300
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City | SOUTH PASADENA
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State | FL
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Zip | 33707-4567
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Country | US
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Telephone | 727-490-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 6006 49TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33709-2148
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Country | US
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Telephone | 727-490-2100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 249412
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME156023
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License Number State | FL
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