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Individual

ETHIRAJ RAMCHANDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1131 E NORTH BLVD, LEESBURG, FL 34748-5375
(352) 365-2333
(352) 365-2024
Mailing address
PO BOX 1739, TAVARES, FL 32778-1739
(352) 365-2333
(352) 365-2024

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0075978
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
43773
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/03/2006
Last updated
02/28/2008
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