MEDICARE: MURALI M ANGIREKULA MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME72836	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21026	OTHER	FL	BLUE CROSS BLUE SHIEDL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588822571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MURALI M ANGIREKULA MD PA

Provider Business Mailing Address
First Line	:	4065 N LECANTO HWY
Second Line	:	SUITE 100
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3555
Country	:	US
Telephone Number	:	352-527-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	4065 N LECANTO HWY
Second Line	:	SUITE 100
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3555
Country	:	US
Telephone Number	:	352-527-2500
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	KAREN LYNNE PHILLIPS
Credential	:	R.N
Telephone Number	:	352-527-2500

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	02/11/2009

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