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General NPI Number Information
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NPI Number | 1912382417
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Entity Type | Individual
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Provider Name | VIVEK VENKATRAMANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2015
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Last Update Date | 05/25/2017
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Provider Practice Location Address
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Address Line | 1250 S MIAMI AVE APT 1311
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City | MIAMI
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State | FL
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Zip | 33130-4107
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Country | US
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Telephone | 786-740-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 S MIAMI AVE APT 1311
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City | MIAMI
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State | FL
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Zip | 33130-4107
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Country | US
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Telephone | 786-740-3330
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | TRN21285
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | MFC1770
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License Number State | FL
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