Basic Information
Provider Information
NPI: 1144220880
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIRJASHANKER
FirstName: RAMESH
MiddleName: NARINE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3300 S FISKE BLVD
Address2:  
City: ROCKLEDGE
State: FL
PostalCode: 329554306
CountryCode: US
TelephoneNumber: 3214343131
FaxNumber: 3219517408
Practice Location
Address1: 1223 GATEWAY DR # 1C
Address2:  
City: MELBOURNE
State: FL
PostalCode: 329012607
CountryCode: US
TelephoneNumber: 3214343131
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/22/2005
LastUpdateDate: 02/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XME 72714FLY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
25447680005FL MEDICAID
43533X01FLMEDICAREOTHER


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