MEDICARE: DR. ISIDORO GUN 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	208600000X	Surgery Physician	24296	FL

General Provider Information

NPI Number	:	1164417051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISIDORO GUN M.D.

Provider Business Mailing Address
First Line	:	19111 COLLINS AVE
Second Line	:	APT 703
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-2376
Country	:	US
Telephone Number	:	305-466-7731
Fax Number	:

Provider Business Practice Location Address
First Line	:	19111 COLLINS AVE
Second Line	:	APT 703
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-2376
Country	:	US
Telephone Number	:	305-466-7731
Fax Number	:

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	08/18/2010

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