Provider Demographics
NPI:1093382137
Name:ANDREW R BUNCE PA
Entity Type:Organization
Organization Name:ANDREW R BUNCE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:786-457-9431
Mailing Address - Street 1:1601 N PALM AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3240
Mailing Address - Country:US
Mailing Address - Phone:786-457-9431
Mailing Address - Fax:
Practice Address - Street 1:1601 N PALM AVE STE 106
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3240
Practice Address - Country:US
Practice Address - Phone:786-457-9431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty