MEDICARE: PREMA L RAMSAHAI DO

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
1	207Q00000X	Family Medicine Physician	OS11257	FL

General Provider Information

NPI Number	:	1578727905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PREMA L RAMSAHAI DO

Provider Business Mailing Address
First Line	:	10647 BIG BEND RD
Second Line	:	STE 212
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7176
Country	:	US
Telephone Number	:	813-844-4600
Fax Number	:	813-844-1960

Provider Business Practice Location Address
First Line	:	10647 BIG BEND RD
Second Line	:	STE 212
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7176
Country	:	US
Telephone Number	:	813-844-4600
Fax Number	:	813-844-1960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	07/16/2013

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Directions to “ PREMA L RAMSAHAI DO” Practice Location

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