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General NPI Number Information
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NPI Number | 1184125338
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Entity Type | Organization
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Legal Business Name | SHIELD MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 4597 CASABLANCA CIR
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City | SEBRING
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State | FL
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Zip | 33870-1206
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Country | US
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Telephone | 863-236-9550
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Fax | 877-832-3363
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Provider Business Mailing Address
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Address Line | PO BOX 919558
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City | ORLANDO
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State | FL
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Zip | 32891-9558
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Country | US
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Telephone | 863-236-9550
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Fax | 863-236-9551
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KULMEET S KUNDLAS
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Credential | MD
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Telephone | 863-255-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME73743
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License Number State | FL
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