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Individual

RAVINDRAN BALAMBAL PALANIYANDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7139 NORTH HIGHWAY US # 1, PORT ST JOHN, FL 32927-5094
(321) 635-8304
(321) 635-8252
Mailing address
6513 RIDGE CT, TITUSVILLE, FL 32780-7404
(321) 269-4464

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME0055762
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060024950
RAILROAD MEDICARE
FL
05
061629000
FL
Enumeration date
07/13/2006
Last updated
06/27/2008
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