Basic Information
| Provider Information | |||||||||
| NPI: | 1124311535 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUGUNA NARASIMHULU | ||||||||
| FirstName: | SUKUMAR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 100296 | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526279350 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1222 S ORANGE AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328061215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076496907 | ||||||||
| FaxNumber: | 4074812035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2011 | ||||||||
| LastUpdateDate: | 08/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0202X | ME116683 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 208000000X | ME116683 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 01065255A | IN | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 266641 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080N0001X | ME116683 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.