Basic Information
| Provider Information | |||||||||
| NPI: | 1093079345 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAVAL | ||||||||
| FirstName: | OJASH | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 224 SANTA BARBARA BLVD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | CAPE CORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339912038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394241449 | ||||||||
| FaxNumber: | 2394241421 | ||||||||
| Practice Location | |||||||||
| Address1: | 4771 S CLEVELAND AVE | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339071317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393439800 | ||||||||
| FaxNumber: | 2393439848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2012 | ||||||||
| LastUpdateDate: | 10/07/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS13593 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 4403 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.