Provider Demographics
NPI:1033504238
Name:JEFFREY R HUNEK MD PA
Entity Type:Organization
Organization Name:JEFFREY R HUNEK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HUNEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-486-1404
Mailing Address - Street 1:2758 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-2464
Mailing Address - Country:US
Mailing Address - Phone:941-486-1404
Mailing Address - Fax:941-486-4146
Practice Address - Street 1:395 COMMERCIAL CT
Practice Address - Street 2:SUITE E
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1649
Practice Address - Country:US
Practice Address - Phone:941-486-1404
Practice Address - Fax:941-486-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93357207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28672ZMedicare PIN
FLI38748Medicare UPIN