Provider Demographics
NPI:1124024047
Name:CUNA, GUILLERMO B (MD)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:B
Last Name:CUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-8240
Mailing Address - Fax:239-343-8241
Practice Address - Street 1:5225 CLAYTON CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:239-343-8240
Practice Address - Fax:239-343-8241
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0059846207Q00000X
FL109076207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1174568091OtherGROUP NPI - FORT WASHINGTON FAMILY MEDICAL CENTER
MD402833300Medicaid
FL008040700Medicaid
DCB776-0020OtherBCBS NCA FOR MEDICAL& SURGICAL CLINICS OF SOUTHERN MARYLAND
MDP00195811OtherMEDICARE RAILROAD
MD62142601 - KR10MEOtherBCBS MARYLAND FOR MEDICAL AND SURGICAL CLINICS OF SOUTHERN MARYLAND
MD1851473722OtherGROUP NPI - MEDICAL & SUGICAL CLINICS OF SOUTHERN MARYLAND
MDH93342Medicare UPIN