Individual
DR. RAUL RAVELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
78 SW 13TH AVE, SUITE 201, MIAMI, FL 33135-2479
(305) 643-0404
(305) 643-0403
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME0045683
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073732
WELLCARE
FL
01
—
11643
BCBS
FL
01
—
209644
AVMED
FL
01
—
4153
DIMENSION
FL
01
—
6363558
CIGNA
FL
01
—
P01598280
RR MEDICARE
FL
01
—
P936576
OPTIMUM
FL
01
—
P995035
FREEDOM
FL
Enumeration date
10/12/2005
Last updated
10/20/2016
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