Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME85117 | FL |
N | 207YP0228X | Pediatric Otolaryngology | ME85117 | FL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | ME85117 | FL |
NPI | 1679541445 |
---|---|
Provider Name | Ram Kumar Madasu |
First Address | Coral Springs, FL 33067-4646 |
Second Address | Coral Springs, FL 33067-4646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 10/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51399A | PIN NUMBER (01) | FL |
F98788 | (02) | FL |