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General NPI Number Information
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NPI Number | 1902802325
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Entity Type | Individual
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Provider Name | RAMASWAMAIAH CHANDRASEKHARA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 01/19/2015
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Provider Practice Location Address
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Address Line | 508 N ALEXANDER ST UNIT 1
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City | PLANT CITY
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State | FL
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Zip | 33563-3036
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Country | US
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Telephone | 813-759-6607
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Fax | 813-759-8997
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Provider Business Mailing Address
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Address Line | 37908 DAUGHTERY RD SUITE A
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-1316
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Country | US
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Telephone | 813-780-8620
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Fax | 813-780-8619
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME32636
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License Number State | FL
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