Provider Demographics
NPI:1295978914
Name:MANN, SUNPREET K (MD)
Entity type:Individual
Prefix:DR
First Name:SUNPREET
Middle Name:K
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNPREET
Other - Middle Name:K
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:4828 COCONUT CREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-247-2168
Practice Address - Fax:844-501-2948
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092039207R00000X, 207RN0300X
FLME129027207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H26358Medicare PIN