MEDICARE: MOUNIKA VATTIGUNTA

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	390200000X	Student in an Organized Health Care Education/Training Program		FL

General Provider Information

NPI Number	:	1245186709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOUNIKA VATTIGUNTA

Provider Business Mailing Address
First Line	:	1208 SEMINOLE BLVD
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-2553
Country	:	US
Telephone Number	:	561-307-6156
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 NW 10TH AVE # 1140
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1015
Country	:	US
Telephone Number	:	561-307-6156
Fax Number	:

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

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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Directions to “ MOUNIKA VATTIGUNTA ” Practice Location

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