Organization Active NPI

Samanaick Ranganathan MD PA

  • Internal Medicine Physician
  • Longwood, FL
National Provider Identifier
1295260289
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME41979 Issued in FL
Legal business name
SAMANAICK RANGANATHAN MD PA
Practice address
1250 W State Road 434
Suite 1004
Longwood, FL 32750-4969
Phone
(407) 260-8227
Fax
(407) 260-2884
NPI assigned
Apr 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Authorized official

Name
Samanaicker Ranganathan, M.D.
Title
Owner
Phone
(407) 260-8227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME41979 FL Primary

Addresses

Primary practice location

1250 W State Road 434
Suite 1004
Longwood, FL 32750-4969

Mailing address

1250 W State Road 434
Suite 1004
Longwood, FL 32750-4969
Phone (407) 260-8227

Other identifiers 2

IdentifierTypeStateIssuer
067397800MedicaidFL
59913OtherFLBLUE CROSS BLUE SHIELD FLORIDA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1295260289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W STATE ROAD 434",
            "address_2": "SUITE 1004",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504969",
            "telephone_number": "407-260-8227",
            "fax_number": "407-260-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W STATE ROAD 434",
            "address_2": "SUITE 1004",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504969",
            "telephone_number": "407-260-8227",
            "fax_number": "407-260-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMANAICK RANGANATHAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "RANGANATHAN",
        "authorized_official_first_name": "SAMANAICKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-260-8227",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME41979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067397800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FLORIDA",
            "identifier": "59913",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.