Rama Bhyravabhotla, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

325 Mdos/Sgomf
340 Magnolia Circle
Tyndall Afb, FL 32403

Phone

(850) 283-7589

Fax

(850) 283-7129

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1215911573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 05 EAGLE DRIVE",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7589",
            "fax_number": "850-283-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MDOS/SGOMF",
            "address_2": "340 MAGNOLIA CIRCLE",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32403",
            "telephone_number": "850-283-7589",
            "fax_number": "850-283-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHYRAVABHOTLA",
        "first_name": "RAMA",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas S. Appleman, O.D.
• Dylan Baker, MD
• Donna Jane Bates
• Oliver Henry Bauer, PSYD
• Heather Danielle Bautista
• Gabrielle Kelly Blankenship, LCSW
• Mandy Lynn Boatright
• Stephanie Salyn Bond, PSYD
• Raywood W Borel, PHARM.D.
• Andrea C Bright, LCSW

• Physician Assistant in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.