Provider Demographics
NPI:1376705830
Name:MAKANI, AMUN (MD)
Entity Type:Individual
Prefix:
First Name:AMUN
Middle Name:
Last Name:MAKANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 5TH WAY N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-2933
Mailing Address - Country:US
Mailing Address - Phone:304-668-0051
Mailing Address - Fax:
Practice Address - Street 1:6450 38TH AVE N STE 320
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1649
Practice Address - Country:US
Practice Address - Phone:727-520-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125098207X00000X
PAMT192858207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery