Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN11869 | FL |
NPI | 1083755029 |
---|---|
Provider Name | Dr. Vyasa Ramcharan |
First Address | Winter Park, FL 32792-4104 |
Second Address | Winter Park, FL 32792-4104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2007 |
Last Update Date | 09/07/2007 |