Provider Demographics
NPI:1588285753
Name:RAMPERSAUD, ANURADHA (PA-C)
Entity type:Individual
Prefix:
First Name:ANURADHA
Middle Name:
Last Name:RAMPERSAUD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20814 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1147
Mailing Address - Country:US
Mailing Address - Phone:305-933-8433
Mailing Address - Fax:305-933-9115
Practice Address - Street 1:20814 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1147
Practice Address - Country:US
Practice Address - Phone:305-933-8433
Practice Address - Fax:305-933-9115
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLPA9115131363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program