Provider Demographics
NPI:1194763094
Name:RAMSOWER, JENIFER (OD)
Entity type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:
Last Name:RAMSOWER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 S HARBOR CITY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1964
Mailing Address - Country:US
Mailing Address - Phone:321-503-2823
Mailing Address - Fax:321-674-9289
Practice Address - Street 1:930 S HARBOR CITY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1964
Practice Address - Country:US
Practice Address - Phone:321-503-2823
Practice Address - Fax:833-365-2167
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3941152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16266OtherBCBS FL
FL621045700Medicaid
FL16266OtherBCBS FL
FLV05983Medicare UPIN
FL5843980001Medicare NSC