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General NPI Number Information
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NPI Number | 1316171036
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Entity Type | Individual
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Provider Name | MAHATHY KATUKURI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 101 E FLORIDA AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-8301
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Country | US
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Telephone | 321-984-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 6414 MODERN DURAN DR
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City | MELBOURNE
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State | FL
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Zip | 32940-2832
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Country | US
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Telephone | 248-631-7496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME116046
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License Number State | FL
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