Provider Demographics
NPI:1750842118
Name:ARUNACHALAM, AMAR
Entity type:Individual
Prefix:
First Name:AMAR
Middle Name:
Last Name:ARUNACHALAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2552
Mailing Address - Country:US
Mailing Address - Phone:561-434-4261
Mailing Address - Fax:561-434-5039
Practice Address - Street 1:3150 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2552
Practice Address - Country:US
Practice Address - Phone:561-351-0204
Practice Address - Fax:561-434-5039
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
FL390200000X
FLME170644207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program