Provider Demographics
NPI:1144415324
Name:JOSEPH, KUNCHERIA (MD)
Entity Type:Individual
Prefix:DR
First Name:KUNCHERIA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 TAMIAMI TRL S
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-4133
Mailing Address - Country:US
Mailing Address - Phone:941-485-6969
Mailing Address - Fax:941-894-6169
Practice Address - Street 1:1101 TAMIAMI TRL S
Practice Address - Street 2:SUITE 202
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-4133
Practice Address - Country:US
Practice Address - Phone:941-485-6969
Practice Address - Fax:941-894-6169
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31818207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58747Medicare UPIN