Individual provider Active NPI

Kunjana Mavunda, M.D.

  • Pediatric Pulmonology Physician
  • South Miami, FL
National Provider Identifier
1457358806
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
ME0047855 Issued in FL
Practice address
6280 Sunset Dr
South Miami, FL 33143-4827
Phone
(305) 668-0075
Fax
(305) 668-6299
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X ME0047855 FL Primary

Addresses

Primary practice location

6280 Sunset Dr
South Miami, FL 33143-4827

Mailing address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515

Other practice location 1

7100 W 20th Ave Ste 616
Hialeah, FL 33016-1814
Phone (305) 556-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708000390 FL Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 0345552113 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0047855FLMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Medical Services, Inc CurrentSince Jul 24, 2013 Accepting new patients
Kidz Medical Services, Inc Pediatric Pulmonology CurrentSince Jul 24, 2013 Accepting new patients
International Travel Clinic Past Accepting new patients

Locations

9980 Central Park Blvd N
Ste 318
Boca Raton, FL 33428
Phone (561) 451-0500

5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668

7100 W 20th Ave
Ste 616
Hialeah, FL 33016
Phone (305) 435-4465

975 Baptist Way
Ste 203
Homestead, FL 33033
Phone (305) 242-8200

6280 Sunset Dr
Ste 607
South Miami, FL 33143
Phone (305) 665-2300

Interoperability endpoints

  • Direct secure messaging: kunjanamavunda@kms.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1457358806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 SUNSET DR",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434827",
            "telephone_number": "305-668-0075",
            "fax_number": "305-668-6299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7100 W 20th Ave Ste 616",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330161814",
            "country_code": "US",
            "telephone_number": "305-556-4263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAVUNDA",
        "first_name": "KUNJANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "ME0047855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.