Provider Demographics
NPI:1871539072
Name:KUMAR, ARAVIND K (MD)
Entity type:Individual
Prefix:
First Name:ARAVIND
Middle Name:K
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2795 W NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3705
Mailing Address - Country:US
Mailing Address - Phone:321-622-8626
Mailing Address - Fax:321-622-8627
Practice Address - Street 1:2795 W NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-3705
Practice Address - Country:US
Practice Address - Phone:321-622-8626
Practice Address - Fax:321-622-8627
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277484400Medicaid
NYI07145Medicare UPIN
FL277484400Medicaid