Provider Demographics
NPI:1225376734
Name:WUNSCH, JESSE ANDREW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:ANDREW
Last Name:WUNSCH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1294
Mailing Address - Country:US
Mailing Address - Phone:727-375-5383
Mailing Address - Fax:727-376-4902
Practice Address - Street 1:5324 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1294
Practice Address - Country:US
Practice Address - Phone:727-375-5383
Practice Address - Fax:727-376-4902
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist