Individual
BHANUPRASAD KONERU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12781 WORLD PLAZA LN, SUITE 1, FORT MYERS, FL 33907-4078
(239) 278-1911
(239) 278-4511
Mailing address
12781 WORLD PLAZA LN, SUITE 1, FORT MYERS, FL 33907-4078
(239) 278-1911
(239) 278-4511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME75079
FL
207RH0003X
Hematology & Oncology Physician
Primary
ME75079
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K6032
MEDICARE GROUP SENDER
FL
Enumeration date
08/13/2006
Last updated
06/19/2022
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