Provider Demographics
NPI:1245456383
Name:B.J. ANARUMO, D.O.,P.A.
Entity type:Organization
Organization Name:B.J. ANARUMO, D.O.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:ANARUMO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-629-3618
Mailing Address - Street 1:18308 MURDOCK CIR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1025
Mailing Address - Country:US
Mailing Address - Phone:941-629-3618
Mailing Address - Fax:941-629-9809
Practice Address - Street 1:18308 MURDOCK CIR UNIT 103
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1025
Practice Address - Country:US
Practice Address - Phone:941-629-3618
Practice Address - Fax:941-629-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 5876208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4244457OtherAETNA
FL80697OtherBLUE CROSS BLUE SHIELD
FL372578200Medicaid
FL650392281OtherHUMANA
FL316596OtherSTAYWELL (WELLCARE) PC
FL316750OtherSTAYWELL (WELLCARE) NP
FL372578201Medicaid
FL650392281OtherHUMANA
FL=========OtherHUMANA MILITARY
FL=========OtherBEECH STREET
FL372578201Medicaid
FL=========OtherUNITED HEALTHCARE
FL=========OtherEVOLUTIONS
FL=========OtherUNITED HEALTHCARE