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General NPI Number Information
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NPI Number | 1952746273
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Entity Type | Organization
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Legal Business Name | KSHAMAYA PANCHAMUKHI MD PA
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 6039 COLLINS AVE 1711
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2203
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Country | US
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Telephone | 305-202-3349
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Fax |
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Provider Business Mailing Address
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Address Line | 6039 COLLINS AVE 1711
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2203
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Country | US
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Telephone | 305-202-3349
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KSHAMAYA B PANCHAMUKHI
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Credential | MD
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Telephone | 305-202-3349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME105527
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License Number State | FL
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