Provider Demographics
NPI:1033473707
Name:ANURUGWO, KINGSLEY NDUBISI (MD)
Entity type:Individual
Prefix:DR
First Name:KINGSLEY
Middle Name:NDUBISI
Last Name:ANURUGWO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CLEMATIS ST STE 5-531
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5107
Mailing Address - Country:US
Mailing Address - Phone:561-671-4036
Mailing Address - Fax:
Practice Address - Street 1:851 AVENUE P
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-7258
Practice Address - Country:US
Practice Address - Phone:561-803-7300
Practice Address - Fax:561-840-0168
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME521062083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine