Provider Demographics
NPI:1447228101
Name:MUNUSWAMY, KARAN (MD)
Entity Type:Individual
Prefix:
First Name:KARAN
Middle Name:
Last Name:MUNUSWAMY
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 1:4725 N FEDERAL HWY
Mailing Address - Street 2:SUITE 401
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-772-2136
Mailing Address - Fax:954-772-7156
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:SUITE 401
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-772-2136
Practice Address - Fax:954-772-7156
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042684207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
10D0284498OtherCLIA #
10D0284498OtherCLIA #
FL39467Medicare ID - Type Unspecified
FLAM2281638OtherDEA #