Healthcare Provider Details

I. General information

NPI: 1164490462
Provider Name (Legal Business Name): JOANNE L BUJNOSKI DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N E ST SUITE 134
PENSACOLA FL
32501-6339
US

IV. Provider business mailing address

PO BOX 18480
PENSACOLA FL
32523-8480
US

V. Phone/Fax

Practice location:
  • Phone: 850-429-7368
  • Fax:
Mailing address:
  • Phone: 850-429-7368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOANNE L BUJNOSKI
Title or Position: PRESIDENT
Credential: DO
Phone: 850-429-7368