Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME86926 | FL |
N | 111NI0900X | Internist | ME86926 | FL |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | ME86926 | FL |
N | 207RC0000X | Internist - Cardiovascular Disease | ME86926 | FL |
NPI | 1689639197 |
---|---|
Provider Name | Mrs. Madhavi Gunda Chunduru |
First Address | Tavernier, FL 33070-9507 |
Second Address | Key Largo, FL 33037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 15/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G35826 | (02) | FL |