NPIMap

Organization Active NPI

Arun K. Penukonda, M.D., F.R.C.S., P.a..

  • Surgery Physician
  • Cape Coral, FL
National Provider Identifier
1265751879
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0062366 Issued in FL
Legal business name
ARUN K. PENUKONDA, M.D., F.R.C.S., P.A..
Practice address
323 Del Prado Blvd. S.
Suite 100
Cape Coral, FL 33990
Phone
(239) 574-4110
Fax
(239) 574-5897
NPI assigned
May 21, 2010
Last updated
Dec 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Arun K Penukonda, M.D.NPI 1215018627
Title
President
Phone
(239) 574-4110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X ME0062366 FL Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X ME0062366 FL

Addresses

Primary practice location

323 Del Prado Blvd. S.
Suite 100
Cape Coral, FL 33990

Mailing address

323 Del Prado Blvd. S.
Suite 100
Cape Coral, FL 33990
Phone (239) 574-4110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1265751879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 DEL PRADO BLVD. S.",
            "address_2": "SUITE 100",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33990",
            "telephone_number": "239-574-4110",
            "fax_number": "239-574-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 DEL PRADO BLVD. S.",
            "address_2": "SUITE 100",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33990",
            "telephone_number": "239-574-4110",
            "fax_number": "239-574-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARUN K. PENUKONDA, M.D., F.R.C.S., P.A..",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-21",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "PENUKONDA",
        "authorized_official_first_name": "ARUN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-574-4110",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0062366",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME0062366",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.