Healthcare Provider Details

I. General information

NPI: 1205452091
Provider Name (Legal Business Name): KUNAL PARMAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 N 12TH AVE
PENSACOLA FL
32504-8918
US

IV. Provider business mailing address

930 MAR WALT DR SUITE C
FORT WALTON BEACH FL
32547-6706
US

V. Phone/Fax

Practice location:
  • Phone: 850-226-6801
  • Fax: 877-413-5104
Mailing address:
  • Phone: 850-226-6801
  • Fax: 877-413-5104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME158201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: