Healthcare Provider Details

I. General information

NPI: 1992128813
Provider Name (Legal Business Name): WILLIAM AARON KUNKLE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 CORPORATE WAY
WEST PALM BEACH FL
33407-2004
US

IV. Provider business mailing address

670 GLADES RD STE 200
BOCA RATON FL
33431-6464
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-9511
  • Fax: 561-990-7426
Mailing address:
  • Phone: 561-495-9511
  • Fax: 561-990-7426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberOS20443
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: