MEDICARE: DR. SAT P PUNYANI 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	207P00000X	Emergency Medicine Physician	ME33922	FL
2	207Q00000X	Family Medicine Physician	ME33922	FL
3	207P00000X	Emergency Medicine Physician	MD038034L	PA

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
2	94111	OTHER	FL	BLUE SHIELD
3	10748820	OTHER		CAQH

General Provider Information

NPI Number	:	1154366623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAT P PUNYANI MD

Provider Business Mailing Address
First Line	:	11613 NW 5TH ST
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33325-1908
Country	:	US
Telephone Number	:	954-547-6981
Fax Number	:	954-424-7543

Provider Business Practice Location Address
First Line	:	11613 NW 5TH ST
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33325-1908
Country	:	US
Telephone Number	:	954-547-6981
Fax Number	:	954-424-7543

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	04/19/2015

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Directions to “ DR. SAT P PUNYANI MD” Practice Location

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