MEDICARE: DR. KUNCHERIA JOSEPH MD

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	ME31818	FL

General Provider Information

NPI Number	:	1144415324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KUNCHERIA JOSEPH MD

Provider Business Mailing Address
First Line	:	1101 TAMIAMI TRL S
Second Line	:	SUITE 202
City	:	VENICE
State	:	FL
Zip	:	34285-4133
Country	:	US
Telephone Number	:	941-485-6969
Fax Number	:	941-894-6169

Provider Business Practice Location Address
First Line	:	1101 TAMIAMI TRL S
Second Line	:	SUITE 202
City	:	VENICE
State	:	FL
Zip	:	34285-4133
Country	:	US
Telephone Number	:	941-485-6969
Fax Number	:	941-894-6169

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

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	09/11/2007

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