Provider Demographics
NPI:1619924966
Name:CHELLUPPARAMPIL, ANNAKUTTY (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANNAKUTTY
Middle Name:
Last Name:CHELLUPPARAMPIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ANNAKUTTY
Other - Middle Name:
Other - Last Name:VADAPARAMPIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1877 NW 128TH TERRACE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028
Mailing Address - Country:US
Mailing Address - Phone:954-438-3339
Mailing Address - Fax:
Practice Address - Street 1:5361 NW 22ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142
Practice Address - Country:US
Practice Address - Phone:305-637-6400
Practice Address - Fax:305-418-2754
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0020553208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBC0342802OtherDRUG ENFORCEMENT AGENCY
D79557Medicare UPIN
FLBC0342802OtherDRUG ENFORCEMENT AGENCY