Provider Demographics
NPI:1134302557
Name:MRUNALINI KAVURI MD PA
Entity Type:Organization
Organization Name:MRUNALINI KAVURI MD PA
Other - Org Name:PRIMARY CARE OF PALM BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MRUNALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-330-3026
Mailing Address - Street 1:2150 LAKE IDA RD
Mailing Address - Street 2:SUITE#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:SUITE#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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98282261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care