MEDICARE: DR. JENNIFER RAY BUNCH 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	207L00000X	Anesthesiology Physician	ME127245	FL
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME127245	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	:	1376830562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER RAY BUNCH M.D.

Provider Business Mailing Address
First Line	:	8839 BRYAN DAIRY RD STE 235
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33777-1207
Country	:	US
Telephone Number	:	727-495-6085
Fax Number	:	727-873-6325

Provider Business Practice Location Address
First Line	:	8839 BRYAN DAIRY RD STE 235
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33777-1207
Country	:	US
Telephone Number	:	727-495-6085
Fax Number	:	727-873-6325

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

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	07/19/2023

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