Provider Demographics
NPI:1124160668
Name:ANNAPOORNA ARUNACHALAM MD PA
Entity type:Organization
Organization Name:ANNAPOORNA ARUNACHALAM MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNAPOORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUNACHALAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-434-4261
Mailing Address - Street 1:3150 SOUTH CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33414-2552
Mailing Address - Country:US
Mailing Address - Phone:866-427-0850
Mailing Address - Fax:561-282-3238
Practice Address - Street 1:3150 SOUTH CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33414-2552
Practice Address - Country:US
Practice Address - Phone:866-427-0850
Practice Address - Fax:561-282-3238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68509207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4340Medicare ID - Type UnspecifiedGROUP ID