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NPI Code Detail

MEDICARE: DR. VINAYAK MADHUSOODANAN MD

MEDICARE: DR. VINAYAK MADHUSOODANAN 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1518594142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINAYAK MADHUSOODANAN MD
Provider Business Mailing Address
First Line : 1200 BRICKELL BAY DR PH 4302
Second Line :
City : MIAMI
State : FL
Zip : 33131-3279
Country : US
Telephone Number : 352-615-8988
Fax Number :
Provider Business Practice Location Address
First Line : 1611 NW 12TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33136-1005
Country : US
Telephone Number : 305-243-3670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2020
Last Update Date : 03/24/2020

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