Healthcare Provider Details

I. General information

NPI: 1972787836
Provider Name (Legal Business Name): SUNIL KUMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 NW 5TH ST STE 103
PLANTATION FL
33317-1611
US

IV. Provider business mailing address

7420 NW 5TH ST STE 103
PLANTATION FL
33317-1611
US

V. Phone/Fax

Practice location:
  • Phone: 954-474-4704
  • Fax: 954-575-7417
Mailing address:
  • Phone: 954-474-4704
  • Fax: 954-575-7417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME71844
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: