MEDICARE: MR. JOSEPH E KUNDROT

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
1	237700000X	Hearing Instrument Specialist	AS4997	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1407410954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH E KUNDROT

Provider Business Mailing Address
First Line	:	2243 W NEW HAVEN AVE STE 102
Second Line	:
City	:	WEST MELBOURNE
State	:	FL
Zip	:	32904-3832
Country	:	US
Telephone Number	:	321-354-9207
Fax Number	:	321-586-2226

Provider Business Practice Location Address
First Line	:	2243 W NEW HAVEN AVE STE 102
Second Line	:
City	:	WEST MELBOURNE
State	:	FL
Zip	:	32904-3832
Country	:	US
Telephone Number	:	321-354-9207
Fax Number	:	321-586-2226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2019
Last Update Date	:	04/30/2019

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Directions to “ MR. JOSEPH E KUNDROT ” Practice Location

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