Ravishankar L Rao M D Pa | |
15435 Cortez Blvd Brooksville FL 34613-6113 | |
(352) 796-2909 | |
(352) 796-8196 |
Full Name | Ravishankar L Rao M D Pa |
---|---|
Speciality | Internal Medicine |
Location | 15435 Cortez Blvd, Brooksville, Florida |
Authorized Official Name and Position | Ravishankar L Rao (OWNER/ DOCTOR) |
Authorized Official Contact | 3527962909 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ravishankar L Rao M D Pa 15435 Cortez Blvd Brooksville FL 34613-6113 Ph: (352) 796-2909 | Ravishankar L Rao M D Pa 15435 Cortez Blvd Brooksville FL 34613-6113 Ph: (352) 796-2909 |
NPI Number | 1184810053 |
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Provider Enumeration Date | 09/24/2007 |
Last Update Date | 03/06/2012 |
Medicare PECOS PAC ID | 1557261286 |
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Medicare Enrollment ID | O20040109000938 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184810053 | NPI | - | NPPES |
257221400 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME 0063596 (Florida) | Primary |
Provider Name | Ravishankar L Rao |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1164414249 PECOS PAC ID: 4082515085 Enrollment ID: I20050317000547 |
Provider Name | Marci Montague |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942858840 PECOS PAC ID: 4082044029 Enrollment ID: I20200415002106 |
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