Healthcare Provider Details

I. General information

NPI: 1447758586
Provider Name (Legal Business Name): BUNCH HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8839 BRYAN DAIRY RD STE 235
LARGO FL
33777-1207
US

IV. Provider business mailing address

8839 BRYAN DAIRY RD STE 235
LARGO FL
33777-1207
US

V. Phone/Fax

Practice location:
  • Phone: 727-495-6085
  • Fax:
Mailing address:
  • Phone: 727-495-6085
  • Fax: 727-873-6325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER RAY BUNCH
Title or Position: OWNER
Credential: MD
Phone: 727-495-6085