MEDICARE: RAMASWAMAIAH CHANDRASEKHARA 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
1	207RG0100X	Gastroenterology Physician	ME32636	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME32636	OTHER	FL	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902802325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMASWAMAIAH CHANDRASEKHARA M.D.

Provider Business Mailing Address
First Line	:	37908 DAUGHTERY RD
Second Line	:	SUITE A
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33541-1316
Country	:	US
Telephone Number	:	813-780-8620
Fax Number	:	813-780-8619

Provider Business Practice Location Address
First Line	:	508 N ALEXANDER ST
Second Line	:	UNIT 1
City	:	PLANT CITY
State	:	FL
Zip	:	33563-3036
Country	:	US
Telephone Number	:	813-759-6607
Fax Number	:	813-759-8997

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	01/19/2015

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