Provider Demographics
NPI:1669962189
Name:KURU, SUGABRAMYA (MD)
Entity type:Individual
Prefix:DR
First Name:SUGABRAMYA
Middle Name:
Last Name:KURU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 CRYSTAL GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-6460
Mailing Address - Country:US
Mailing Address - Phone:813-949-4991
Mailing Address - Fax:813-949-4986
Practice Address - Street 1:208 CRYSTAL GROVE BLVD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-6460
Practice Address - Country:US
Practice Address - Phone:813-949-4991
Practice Address - Fax:813-949-4986
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME149802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine