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NPI Code Detail

MEDICARE: HEIDI L KUNSTMAN M.D.

MEDICARE: HEIDI L KUNSTMAN 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
1208000000XPediatrics PhysicianME87668FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
271526OTHERFLBLUE CROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811988702
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI L KUNSTMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 1357
Second Line :
City : FORT MYERS
State : FL
Zip : 33902-1357
Country : US
Telephone Number : 239-278-3600
Fax Number : 239-226-4650
Provider Business Practice Location Address
First Line : 930 S MAIN ST
Second Line :
City : LABELLE
State : FL
Zip : 33935-4444
Country : US
Telephone Number : 863-675-0160
Fax Number : 863-675-6219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 05/04/2017

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Directions to “ HEIDI L KUNSTMAN M.D.” Practice Location

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