Provider Demographics
NPI:1316049679
Name:KUMAR, MARIANANDA P (MD)
Entity type:Individual
Prefix:MR
First Name:MARIANANDA
Middle Name:P
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3400 N LECANTO HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465
Mailing Address - Country:US
Mailing Address - Phone:352-746-2227
Mailing Address - Fax:352-746-3587
Practice Address - Street 1:3400 N LECANTO HWY
Practice Address - Street 2:SUITE A
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465
Practice Address - Country:US
Practice Address - Phone:352-746-2227
Practice Address - Fax:352-746-3587
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL660076000Medicaid
FL09649OtherBCBS OF FLORIDA
FL052192127Medicaid
FL110162127OtherRAILROAD MEDICARE PIN
FLCN2848OtherRAILROAD MEDICARE GROUP
FL09649WMedicare PIN
E59512Medicare UPIN