MEDICARE: DHARANI MUDUGAL M.D.

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	2084N0400X	Neurology Physician	29359	NE
2	2084N0400X	Neurology Physician	73277	MN
3	2084N0400X	Neurology Physician	ME168685	FL

General Provider Information

NPI Number	:	1346555299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DHARANI MUDUGAL M.D.

Provider Business Mailing Address
First Line	:	265 E ROLLINS ST # 6
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5502
Country	:	US
Telephone Number	:	407-303-6729
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 E ROLLINS ST # 6
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5502
Country	:	US
Telephone Number	:	407-303-6729
Fax Number	:

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

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	07/18/2024

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