Individual
DR. ANKEM RAVINDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 W US HWY 90, STE 101, LAKE CITY, FL 32055
(386) 752-3400
(386) 752-3110
Mailing address
1740 W US HWY 90, STE 101, LAKE CITY, FL 32055
(386) 752-3400
(386) 752-3110
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME38632
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065750600
—
FL
01
—
110131270
RR MEDICARE
—
Enumeration date
06/21/2006
Last updated
12/18/2009
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