Basic Information
| Provider Information | |||||||||
| NPI: | 1649428764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUNNI | ||||||||
| FirstName: | HALA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8110 ROYAL PALM BLVD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330655795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543418277 | ||||||||
| FaxNumber: | 9543415165 | ||||||||
| Practice Location | |||||||||
| Address1: | 8110 ROYAL PALM BLVD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330655795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543418277 | ||||||||
| FaxNumber: | 9543415165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2008 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | ME126413 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | 0064910 | 05 | OH | MEDICAID | 016762800 | 05 | FL | MEDICAID |