Provider Demographics
NPI:1710220314
Name:SIRAM, RAMCHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:RAMCHANDRA
Middle Name:
Last Name:SIRAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N ALAFAYA TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4316
Mailing Address - Country:US
Mailing Address - Phone:407-282-4400
Mailing Address - Fax:407-282-4191
Practice Address - Street 1:250 N ALAFAYA TRL STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828
Practice Address - Country:US
Practice Address - Phone:407-282-4400
Practice Address - Fax:407-282-4191
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2228207Q00000X, 207QG0300X
390200000X
FLME138395207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program