MEDICARE: DR. ANUPAM KUMAR MOHANTY 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	207R00000X	Internal Medicine Physician	MD435931	PA
2	207RI0008X	Hepatology Physician	ME96325	FL
3	207R00000X	Internal Medicine Physician	ME96325	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578743381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANUPAM KUMAR MOHANTY MD

Provider Business Mailing Address
First Line	:	335 S BISCAYNE BLVD APT 3201
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2351
Country	:	US
Telephone Number	:	610-547-9437
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-3137
Country	:	US
Telephone Number	:	786-648-7200
Fax Number	:	786-648-7211

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

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	07/06/2020

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