Provider Demographics
NPI:1063919686
Name:PURI, AJAY KUMAR (MD)
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:KUMAR
Last Name:PURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NW 9TH AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1100
Mailing Address - Country:US
Mailing Address - Phone:305-355-5808
Mailing Address - Fax:
Practice Address - Street 1:1801 NW 9TH AVE STE 700
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1100
Practice Address - Country:US
Practice Address - Phone:305-355-5808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309562207P00000X
FL168468207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine