MEDICARE: DR. EMIE KUYUMJIAN 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	207Q00000X	Family Medicine Physician	ME105138	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00756984	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3473979	OTHER	FL	CIGNA
3	145X8	OTHER	FL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962602482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMIE KUYUMJIAN M.D.

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE FL 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9342
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:

Provider Business Practice Location Address
First Line	:	3571 DEL PRADO BLVD N
Second Line	:	SUITE 2
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-5286
Country	:	US
Telephone Number	:	239-656-6300
Fax Number	:	239-656-6765

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

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	02/06/2024

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Directions to “ DR. EMIE KUYUMJIAN M.D.” Practice Location

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