Individual
ANAND MATHAI KURUVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 ZEAGLER DR, SUITE 2, PALATKA, FL 32177-3811
(386) 325-8140
(904) 350-0032
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME59637
FL
2085R0001X
Radiation Oncology Physician
Primary
ME59637
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055904100
—
FL
01
—
0571795
CIGNA
FL
01
—
1115823
CARE PLUS
FL
01
—
1121651
WELLCARE
FL
01
—
1193327
WELLCARE
FL
01
—
12258
BCBS
FL
01
—
204458
AVMED
FL
01
—
4235259
AETNA
FL
01
—
P00198033
MEDICARE RAILROAD
—
01
—
P01451915
RR MEDICARE
FL
01
—
P01596516
RR MEDICARE
FL
Enumeration date
04/25/2006
Last updated
05/04/2016
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