Provider Demographics
NPI:1649428764
Name:BUNNI, HALA (MD)
Entity type:Individual
Prefix:
First Name:HALA
Middle Name:
Last Name:BUNNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8110 ROYAL PALM BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5795
Mailing Address - Country:US
Mailing Address - Phone:954-341-8277
Mailing Address - Fax:954-341-5165
Practice Address - Street 1:8110 ROYAL PALM BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5795
Practice Address - Country:US
Practice Address - Phone:954-341-8277
Practice Address - Fax:954-341-5165
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126413207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0064910Medicaid
FL016762800Medicaid