Individual
ARUN K PENUKONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FRCS, PA
Contact information
Practice address
323 DEL PRADO BLVD. S., SUITE 100, CAPE CORAL, FL 33990
(239) 574-4110
(239) 673-6053
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(239) 574-4110
(239) 574-5897
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0062366
FL
2086S0129X
Vascular Surgery Physician
ME0062366
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370617600
—
FL
Enumeration date
10/19/2006
Last updated
10/27/2021
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