Basic Information
| Provider Information | |||||||||
| NPI: | 1679675953 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMAKRISHNA | ||||||||
| FirstName: | RAVINDRA | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8600 SW 92ND ST STE 204A | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331567377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052167312 | ||||||||
| FaxNumber: | 3052167312 | ||||||||
| Practice Location | |||||||||
| Address1: | 3659 S MIAMI AVE STE 5008 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331334221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058540616 | ||||||||
| FaxNumber: | 3058544384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2006 | ||||||||
| LastUpdateDate: | 10/21/2018 | ||||||||
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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 | 207R00000X | 036110048 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | MT198254 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | ME111379 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 006294300 | 05 | FL | MEDICAID |