Organization
RETINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAM PEDDADA MD (OWNER)
(307) 797-2666
Entity
Organization
Contact information
Practice address
5800 COLONIAL DR, SUITE 300, MARGATE, FL 33063-5682
(954) 975-0044
Mailing address
5800 COLONIAL DR, SUITE 300, MARGATE, FL 33063-5682
(954) 975-0044
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME 113019
FL
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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