Provider Demographics
NPI:1699923060
Name:RAMDATH, SONA JR (DPM)
Entity type:Individual
Prefix:
First Name:SONA
Middle Name:
Last Name:RAMDATH
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 N WOODLAND BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-2713
Mailing Address - Country:US
Mailing Address - Phone:386-279-0540
Mailing Address - Fax:386-279-0571
Practice Address - Street 1:843 N WOODLAND BLVD STE 2
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-2713
Practice Address - Country:US
Practice Address - Phone:386-279-0540
Practice Address - Fax:386-279-0571
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3482213ES0103X
FLPO3492213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107802400Medicaid