MEDICARE: LATOYA TUNISE KUESTER M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME 105615	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	:	1487717559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA TUNISE KUESTER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 748817
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-8817
Country	:	US
Telephone Number	:	813-286-0333
Fax Number	:	813-282-1806

Provider Business Practice Location Address
First Line	:	1411 S 14TH ST STE D
Second Line	:
City	:	FERNANDINA
State	:	FL
Zip	:	32034-3092
Country	:	US
Telephone Number	:	904-321-0064
Fax Number	:	904-491-3113

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	06/22/2023

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