Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME0047855 | FL |
NPI | 1457358806 |
---|---|
Provider Name | Dr. Kunjana Mavunda |
First Address | Coral Gables, FL 33146-2423 |
Second Address | South Miami, FL 33143-4827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E14438 | (02) | FL |