Look up the most recent NPI and PECOS records

Raja Ramesh Gummalla

Internal Medicine

Allopathic & Osteopathic Physicians

(305) 243-1959

PECOS Enrollment

Based on the most recent information from CMS, provider Raja Ramesh Gummalla is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1952618951
Provider Type
Individual
Full Name
Gummalla, Raja Ramesh
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
9/12/2010
Last Updated
8/1/2016

Contact Information

Practice Location

1400 NW 12th Ave, Miami, FL 33136-1003

(305) 243-1959

Unlisted Fax

Mailing Location

1400 NW 12th Ave, Miami, FL 33136-1003

(305) 243-1959

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME116336 Florida
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 125057359 Illinois

Raja Ramesh Gummalla

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Murman, Magdalena

Bowen, Mikayla

Ghali, Sherin

Woolger, Judi M

Raffa, Gabriella

Fernandez-Nosti, Yanelys R

Zaw, Khin M

Avallone, Stephen V

Quintana, Christian Alexander

Milanes, Hermes