Organization
KAPIL PURI MD P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAPIL PURI M.D. (PRESIDENT)
(850) 279-4600
Entity
Organization
Contact information
Practice address
1001 COLLEGE BLVD W, STE H, NICEVILLE, FL 32578-1099
(850) 279-4600
(850) 279-4566
Mailing address
PO BOX 524, NICEVILLE, FL 32588-0524
(850) 279-4500
(850) 279-4566
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME91106
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270922800
—
FL
01
—
AK816
MEDICARE ID-TYPE UNSPECIFIED
FL
Enumeration date
03/02/2008
Last updated
08/21/2008
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