Organization
FLORIDA ID CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIVAKUMAR RAMAN (MEDICAL DIRECTOR)
(239) 245-8223
Entity
Organization
Contact information
Practice address
3540 STUART CT, FORT MYERS, FL 33901-7737
(609) 350-4757
(239) 244-9481
Mailing address
14192 METROPOLIS AVE, FORT MYERS, FL 33912-4331
(239) 245-8223
(239) 244-9481
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME100391
FL
Other
Enumeration date
04/06/2012
Last updated
04/13/2016
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