Individual
MR. PUDICHERY KUNJAVARA PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 HARVARD ST, BROOKSVILLE, FL 34601-2842
(352) 799-3555
(352) 796-9299
Mailing address
705 HARVARD ST, BROOKSVILLE, FL 34601-2842
(352) 799-3555
(352) 799-9299
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0037402
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065645300
—
FL
Enumeration date
11/08/2005
Last updated
08/21/2019
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