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General NPI Number Information
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NPI Number | 1720465511
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Entity Type | Individual
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Provider Name | SHARMILA RAVINDRANATHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 20900 BISCAYNE BLVD #826
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City | AVENTURA
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State | FL
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Zip | 33180
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Country | US
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Telephone | 305-682-5293
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Fax | 305-682-5253
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Provider Business Mailing Address
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Address Line | 1225 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90017-1901
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A178181
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License Number State | CA
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