Provider Demographics
NPI:1962775353
Name:RALPH GARRAMONE MD PA
Entity type:Organization
Organization Name:RALPH GARRAMONE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:GARRAMONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-482-1900
Mailing Address - Street 1:12998 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3849
Mailing Address - Country:US
Mailing Address - Phone:239-482-1900
Mailing Address - Fax:239-437-0433
Practice Address - Street 1:12998 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3849
Practice Address - Country:US
Practice Address - Phone:239-482-1900
Practice Address - Fax:239-437-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75131208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
35351Medicare UPIN