Provider Demographics
NPI:1699527085
Name:BABU, ARUN
Entity type:Individual
Prefix:
First Name:ARUN
Middle Name:
Last Name:BABU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10444 RIVERDALE RISE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4074
Mailing Address - Country:US
Mailing Address - Phone:813-452-0055
Mailing Address - Fax:
Practice Address - Street 1:10444 RIVERDALE RISE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4074
Practice Address - Country:US
Practice Address - Phone:813-452-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program