Individual
DR. PUNAM PRABHAKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13782 PLANTATION RD STE 201, FORT MYERS, FL 33912-4462
(239) 343-1290
(239) 343-4008
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-1290
(239) 343-4008
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01083325A
IN
2084N0400X
Neurology Physician
876242
NY
2084N0400X
Neurology Physician
Primary
ME92844
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110868100
—
FL
Enumeration date
02/14/2007
Last updated
11/10/2021
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