Shanmukha Sai Mukthapuram, MD | |
10101 Forest Hill Blvd, Wellington, FL 33414-6103 | |
(561) 798-8500 | |
Not Available |
Full Name | Shanmukha Sai Mukthapuram |
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Gender | Male |
Speciality | Pediatrics - Neonatal-perinatal Medicine |
Location | 10101 Forest Hill Blvd, Wellington, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1376983536 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 35.128161 (Ohio) | Secondary |
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | ME160215 (Florida) | Primary |
Entity Name | Children's Hospital Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609915784 PECOS PAC ID: 8426955733 Enrollment ID: O20031216000035 |
Mailing Address | Practice Location Address |
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Shanmukha Sai Mukthapuram, MD 3180 S Ocean Dr Apt 1408, Hallandale Beach, FL 33009-7252 Ph: (929) 234-9843 | Shanmukha Sai Mukthapuram, MD 10101 Forest Hill Blvd, Wellington, FL 33414-6103 Ph: (561) 798-8500 |
Middey Damian, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1447 Medical Park Blvd Ste 104, Wellington, FL 33414 Phone: 561-792-1525 Fax: 561-782-1521 | |
Mohamed Chan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 468 Old Country Rd, Wellington, FL 33414 Phone: 561-676-5164 | |
Dr. Michael L. Bruck, M.D., F.A.A.P. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 10115 W Forest Hill Blvd., Suite 402, Wellington, FL 33414 Phone: 561-791-1935 Fax: 561-791-0115 | |
Dr. Lawrence Russell Bergman, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 10115 W Forest Hill Blvd, Ste 303, Wellington, FL 33414 Phone: 561-798-5565 Fax: 561-798-9756 | |
Dr. Edith Michelle Spencer-morales, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 10101 Forest Hill Blvd, Wellington, FL 33414 Phone: 561-798-8599 | |
Dr. Jodi Ellen Star, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Guiding Light Wellness Center, 3319 State Road 7 Ste 210, Wellington, FL 33449 Phone: 561-422-3314 Fax: 561-422-3315 | |
Dr. Nataliya G. Stumbo, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1447 Medical Park Blvd, Suite 402, Wellington, FL 33414 Phone: 561-790-2600 Fax: 561-790-1535 |