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NPI Code Detail

MEDICARE: AVIANNE BUNNELL MD

MEDICARE:   AVIANNE  BUNNELL  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0129XVascular Surgery PhysicianME140604FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285066019
Entity Type Code : Individual
Provider Name (Legal Business Name) : AVIANNE BUNNELL MD
Provider Business Mailing Address
First Line : 5880 49TH ST N STE 206
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33709-2147
Country : US
Telephone Number : 727-999-8346
Fax Number : 877-743-4465
Provider Business Practice Location Address
First Line : 5880 49TH ST N STE 206
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33709-2147
Country : US
Telephone Number : 727-999-8346
Fax Number : 778-743-4465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2013
Last Update Date : 09/24/2024

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Directions to “ AVIANNE BUNNELL MD” Practice Location

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