Individual
DR. VENKATACHALAM SHANMUGASUNDARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10131 W FOREST HILL BLVD, SUITE 201, WELLINGTON, FL 33414-6156
(561) 798-6767
(561) 795-2706
Mailing address
10131 W FOREST HILL BLVD STE 201, WELLINGTON, FL 33414-6109
(561) 798-6767
(561) 795-2706
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME0045705
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00446
WELLCARE
FL
01
—
0067235
GHI
FL
05
—
040885901
—
FL
01
—
0854223
AETNA
FL
01
—
1002118
UNITED HEALTHCARE
FL
01
—
205868
AMERIGROUP
FL
01
—
3370WELL
NIEGHBORHOOD PATNERS
FL
01
—
592607590
CHAMPUS
FL
01
—
592607590A
HUMANA
FL
01
—
61449
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/14/2005
Last updated
04/24/2020
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