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General NPI Number Information
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NPI Number | 1457358806
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Entity Type | Individual
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Provider Name | KUNJANA MAVUNDA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 6280 SUNSET DR
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4827
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Country | US
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Telephone | 305-668-0075
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Fax | 305-668-6299
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Provider Business Mailing Address
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Address Line | 5955 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33146-2423
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Country | US
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Telephone | 305-661-1515
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Fax | 305-662-3723
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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 | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | ME0047855
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License Number State | FL
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