MEDICARE: SUGUNA R. KONA 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	207R00000X	Internal Medicine Physician	ME84995	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326045543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUGUNA R. KONA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 25487
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34277-2487
Country	:	US
Telephone Number	:	941-202-5342
Fax Number	:	855-253-4836

Provider Business Practice Location Address
First Line	:	4502 CORTEZ RD W STE 205
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-3124
Country	:	US
Telephone Number	:	941-259-8505
Fax Number	:	941-792-7152

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	08/25/2020

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