MEDICARE: MRS. ANNAKUTTY CHELLUPPARAMPIL 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	208000000X	Pediatrics Physician	0020553	FL

General Provider Information

NPI Number	:	1619924966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNAKUTTY CHELLUPPARAMPIL MD

Provider Business Mailing Address
First Line	:	1877 NW 128TH TERRACE
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028
Country	:	US
Telephone Number	:	954-438-3339
Fax Number	:

Provider Business Practice Location Address
First Line	:	5361 NW 22ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142
Country	:	US
Telephone Number	:	305-637-6400
Fax Number	:	305-418-2754

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	03/07/2023

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