Basic Information
Provider Information
NPI: 1093710907
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMSTAD
FirstName: MARGARET
MiddleName: LEGER
NamePrefix: MS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 303 N CLYDE MORRIS BLVD
Address2:  
City: DAYTONA BEACH
State: FL
PostalCode: 321142709
CountryCode: US
TelephoneNumber: 3862544000
FaxNumber: 3862264577
Practice Location
Address1: 303 N CLYDE MORRIS BLVD
Address2:  
City: DAYTONA BEACH
State: FL
PostalCode: 321142709
CountryCode: US
TelephoneNumber: 3862578750
FaxNumber: 3863224720
Other Information
ProviderEnumerationDate: 06/16/2005
LastUpdateDate: 01/19/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XARNP3139192FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


Home