MEDICARE: JORGE A KUSNIR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	ME0067778	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	390003710	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26635	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	207369	OTHER	FL	AVMED

General Provider Information

NPI Number	:	1063405108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE A KUSNIR M.D.

Provider Business Mailing Address
First Line	:	807 S ORLANDO AVE
Second Line	:	SUITE C
City	:	WINTER PARK
State	:	FL
Zip	:	32789-4870
Country	:	US
Telephone Number	:	407-894-4693
Fax Number	:	407-539-0469

Provider Business Practice Location Address
First Line	:	2501 N ORANGE AVE
Second Line	:	SUITE 537N
City	:	ORLANDO
State	:	FL
Zip	:	32804-4603
Country	:	US
Telephone Number	:	407-894-4693
Fax Number	:	407-896-0569

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	12/23/2009

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Directions to “ JORGE A KUSNIR M.D.” Practice Location

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