Provider Demographics
NPI:1003271909
Name:DR. SARITA MUNUSWAMY
Entity Type:Organization
Organization Name:DR. SARITA MUNUSWAMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNUSWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-785-6343
Mailing Address - Street 1:1600 N FEDERAL HWY STE B
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-3229
Mailing Address - Country:US
Mailing Address - Phone:954-785-6343
Mailing Address - Fax:954-785-4322
Practice Address - Street 1:1600 N FEDERAL HWY STE B
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-3229
Practice Address - Country:US
Practice Address - Phone:954-785-6343
Practice Address - Fax:954-785-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42836261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068032000Medicaid