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NPI Code Detail

MEDICARE: RONALD C PRATI JR. M.D.

MEDICARE: RONALD C PRATI JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianME68801FL
22085R0204XVascular & Interventional Radiology PhysicianME68801FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127453OTHERFLBCBS OF FLORIDA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194722157
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD C PRATI JR. M.D.
Provider Business Mailing Address
First Line : 4149 SUN N LAKE BLVD.
Second Line :
City : SEBRING
State : FL
Zip : 33872
Country : US
Telephone Number : 863-314-0165
Fax Number : 863-385-2582
Provider Business Practice Location Address
First Line : 4200 SUN N LAKE BLVD
Second Line :
City : SEBRING
State : FL
Zip : 33872-1986
Country : US
Telephone Number : 863-402-3447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 09/09/2010

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