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General NPI Number Information
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NPI Number | 1972878346
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Entity Type | Organization
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Legal Business Name | KUTTY K CHANDRAN, MD, PA.
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Dates
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Enumeration Date | 03/18/2012
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Last Update Date | 03/18/2012
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Provider Practice Location Address
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Address Line | 10161 W SAMPLE RD SUITE B
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3954
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Country | US
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Telephone | 954-755-6400
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Fax | 954-753-5172
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Provider Business Mailing Address
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Address Line | 10161 W SAMPLE RD SUITE B
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3954
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Country | US
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Telephone | 954-755-6400
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Fax | 954-753-5172
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. KUTTY K CHANDRAN
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Credential | MD
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Telephone | 954-755-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME54935
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License Number State | FL
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