Provider Demographics
NPI:1154366623
Name:PUNYANI, SAT P (MD)
Entity type:Individual
Prefix:DR
First Name:SAT
Middle Name:P
Last Name:PUNYANI
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 1:11613 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325-1908
Mailing Address - Country:US
Mailing Address - Phone:954-547-6981
Mailing Address - Fax:954-424-7543
Practice Address - Street 1:11613 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33325-1908
Practice Address - Country:US
Practice Address - Phone:954-547-6981
Practice Address - Fax:954-424-7543
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2015-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME33922207P00000X, 207Q00000X
PAMD038034L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044437501Medicaid
FL94111OtherBLUE SHIELD
10748820OtherCAQH
FL94111OtherBLUE SHIELD
10748820OtherCAQH