Provider Demographics
NPI:1275157950
Name:TUNSIL, KIAMBE B
Entity Type:Individual
Prefix:
First Name:KIAMBE
Middle Name:B
Last Name:TUNSIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 SW 13TH STREET
Mailing Address - Street 2:HR CREDENTIALING
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608
Mailing Address - Country:US
Mailing Address - Phone:352-374-5600
Mailing Address - Fax:352-374-5600
Practice Address - Street 1:103 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-0920
Practice Address - Country:US
Practice Address - Phone:352-439-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)