Provider Demographics
NPI:1356607329
Name:MARIS G RAMSAY DO PA
Entity type:Organization
Organization Name:MARIS G RAMSAY DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAMSAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-855-0154
Mailing Address - Street 1:9460 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8321
Mailing Address - Country:US
Mailing Address - Phone:407-855-0154
Mailing Address - Fax:
Practice Address - Street 1:9460 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8321
Practice Address - Country:US
Practice Address - Phone:407-855-0154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0004731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053517600Medicaid
D60696Medicare UPIN
FL053517600Medicaid