Provider Demographics
NPI:1780720219
Name:KUBAL, AARUP ANANT (MD)
Entity type:Individual
Prefix:
First Name:AARUP
Middle Name:ANANT
Last Name:KUBAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 N PINE ISLAND RD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5233
Mailing Address - Country:US
Mailing Address - Phone:954-452-9922
Mailing Address - Fax:954-452-9481
Practice Address - Street 1:1776 N PINE ISLAND RD
Practice Address - Street 2:SUITE 214
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5233
Practice Address - Country:US
Practice Address - Phone:954-452-9922
Practice Address - Fax:954-452-9481
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN51607207W00000X
CAA113132207W00000X
FLME 107766207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN51607OtherMN STATE MD LICENSE
MN1780720219Medicaid
MN1780720219Medicaid