Healthcare Provider Details

I. General information

NPI: 1609816396
Provider Name (Legal Business Name): AMBIKA SURESHKUMAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBIKA KATHIRGAMATHAMBY

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 S POWERLINE RD BAY 16
POMPANO BEACH FL
33069-4316
US

IV. Provider business mailing address

8333 NW 53RD ST FL 6
DORAL FL
33166-4783
US

V. Phone/Fax

Practice location:
  • Phone: 954-970-7272
  • Fax: 954-970-0282
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD098972L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME123600
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: