Organization
EYYUNNI PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMANUJAM EYYUNNI MD (OWNER)
(904) 819-0101
Entity
Organization
Contact information
Practice address
201 HEALTH PARK BLVD, SUITE 107, ST AUGUSTINE, FL 32086-5796
(904) 819-0101
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 824-4990
(904) 824-2226
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
ME82671
FL
208600000X
Surgery Physician
Primary
ME81943
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002377800
—
FL
01
—
DG4055
RR MEDICARE
FL
Enumeration date
01/24/2007
Last updated
08/19/2011
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