MEDICARE: DR. ARUL B CHIDAMBARAM 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
1	208600000X	Surgery Physician	ME79993	FL
2	2086S0129X	Vascular Surgery Physician	ME79993	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154316727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARUL B CHIDAMBARAM MD

Provider Business Mailing Address
First Line	:	6415 LAKE WORTH RD STE 102
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3009
Country	:	US
Telephone Number	:	561-331-0808
Fax Number	:	561-798-9282

Provider Business Practice Location Address
First Line	:	12955 PALMS WEST DR STE 101
Second Line	:
City	:	LOXAHATCHEE
State	:	FL
Zip	:	33470-9212
Country	:	US
Telephone Number	:	561-798-1515
Fax Number	:	561-798-9282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	08/12/2019

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Directions to “ DR. ARUL B CHIDAMBARAM MD” Practice Location

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