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NPI Code Detail

MEDICARE: DR. SUNIL MOHAN MALKANI MD

MEDICARE: DR. SUNIL MOHAN MALKANI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianME81904FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
158642SOTHERFLMEDICARE
258642ROTHERFLMEDICARE OTHER

General Provider Information

NPI Number : 1134191976
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUNIL MOHAN MALKANI MD
Provider Business Mailing Address
First Line : 9201 CYPRESS LAKE DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-4941
Country : US
Telephone Number : 239-324-4888
Fax Number : 877-717-0096
Provider Business Practice Location Address
First Line : 9201 CYPRESS LAKE DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-9310
Country : US
Telephone Number : 239-324-4888
Fax Number : 877-717-0096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 10/24/2014

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