=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366405136
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | H. S. RAMESH M.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2006
-----------------------------------------------------
Last Update Date | 04/03/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 325 CLYDE MORRIS BLVD STE 400
-----------------------------------------------------
City | ORMOND BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32174-8185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-671-0600
-----------------------------------------------------
Fax | 386-677-9710
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 325 CLYDE MORRIS BLVD STE 400
-----------------------------------------------------
City | ORMOND BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32174-8185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-671-0600
-----------------------------------------------------
Fax | 386-677-9710
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2081P2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | WV17815
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2081P2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | ME131188
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------