Provider Demographics
NPI:1063639516
Name:KAVURI, MRUNALINI (MD)
Entity Type:Individual
Prefix:
First Name:MRUNALINI
Middle Name:
Last Name:KAVURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2150 LAKE IDA RD
Mailing Address - Street 2:# 5
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2443
Mailing Address - Country:US
Mailing Address - Phone:561-330-3026
Mailing Address - Fax:561-330-3027
Practice Address - Street 1:2150 LAKE IDA RD
Practice Address - Street 2:# 5
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2443
Practice Address - Country:US
Practice Address - Phone:561-330-3026
Practice Address - Fax:561-330-3027
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301084122207QH0002X
FLME98282207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine