Provider Demographics
NPI:1083659148
Name:ARUNACHALAM, ANNAPOORNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNAPOORNA
Middle Name:
Last Name:ARUNACHALAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2552
Mailing Address - Country:US
Mailing Address - Phone:561-434-4261
Mailing Address - Fax:561-434-5039
Practice Address - Street 1:3150 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2552
Practice Address - Country:US
Practice Address - Phone:561-434-4261
Practice Address - Fax:561-434-5039
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68509207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16338OtherHEALTH EASE ID
FL650937559OtherFIRST HEALTH INSURANCE ID
FLG14494OtherVISTA HEALTH ID
FL379873900Medicaid
FL650937559OtherHUMANA ID
FL910754100OtherFL NETPASS ID
FL0005387139OtherAETNA ID
FL43334OtherNEIGHBORHOOD HEALTH ID
FL104164OtherAVMED ID
FL460003791OtherMEDICARE RAILROAD ID
FL17995OtherTOTAL HEALTH CHOICE ID
FL28216OtherBCBS ID
NY6011408OtherGHI ID
FL650937559OtherUNITED HEALTH CARE ID
FL28216OtherBCBS ID
FL43334OtherNEIGHBORHOOD HEALTH ID