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Organization
SAMANAICK RANGANATHAN MD PA
Active
Organization
SAMANAICK RANGANATHAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANAICKER RANGANATHAN M.D. (OWNER)
(407) 260-8227
Entity
Organization
Contact information
Practice address
1250 W STATE ROAD 434, SUITE 1004, LONGWOOD, FL 32750-4969
(407) 260-8227
(407) 260-2884
Mailing address
1250 W STATE ROAD 434, SUITE 1004, LONGWOOD, FL 32750-4969
(407) 260-8227
(407) 260-2884
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME41979
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067397800
—
FL
01
—
59913
BLUE CROSS BLUE SHIELD FLORIDA
FL
Enumeration date
04/27/2017
Last updated
04/27/2017
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