Basic Information
| Provider Information | |||||||||
| NPI: | 1558629659 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMNARAIGN | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | HEMENDRA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 100278 | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100278 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522737832 | ||||||||
| FaxNumber: | 3522736867 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 SW ARCHER RD | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326102612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522737832 | ||||||||
| FaxNumber: | 3522736867 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2012 | ||||||||
| LastUpdateDate: | 02/25/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME141328 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | ME141328 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RH0003X | ME141328 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 103360400 | 05 | FL | MEDICAID |