Provider Demographics
NPI:1710942206
Name:ANGIREKULA, MURALI MOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MURALI
Middle Name:MOHAN
Last Name:ANGIREKULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4065 N LECANTO HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465-3555
Mailing Address - Country:US
Mailing Address - Phone:352-527-2500
Mailing Address - Fax:352-527-2504
Practice Address - Street 1:4065 N. LECANTO HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465
Practice Address - Country:US
Practice Address - Phone:352-527-2500
Practice Address - Fax:352-527-2504
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72836208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG33868Medicare UPIN
FL21026CMedicare ID - Type Unspecified