Healthcare Provider Details

I. General information

NPI: 1649428764
Provider Name (Legal Business Name): HALA BUNNI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 ROYAL PALM BLVD SUITE 108
CORAL SPRINGS FL
33065-5795
US

IV. Provider business mailing address

8110 ROYAL PALM BLVD SUITE 108
CORAL SPRINGS FL
33065-5795
US

V. Phone/Fax

Practice location:
  • Phone: 954-341-8277
  • Fax: 954-341-5165
Mailing address:
  • Phone: 954-341-8277
  • Fax: 954-341-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME126413
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: