Individual
SHANMUKHA SAI MUKTHAPURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10101 FOREST HILL BLVD, WELLINGTON, FL 33414-6103
(561) 798-8500
Mailing address
3180 S OCEAN DR APT 1408, HALLANDALE BEACH, FL 33009-7252
(929) 234-9843
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.128161
OH
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME160215
FL
Other
Enumeration date
07/02/2013
Last updated
02/12/2024
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