Provider Demographics
NPI:1407410954
Name:KUNDROT, JOSEPH E
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:KUNDROT
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 1:2243 W NEW HAVEN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3832
Mailing Address - Country:US
Mailing Address - Phone:321-354-9207
Mailing Address - Fax:321-586-2226
Practice Address - Street 1:2243 W NEW HAVEN AVE STE 102
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-3832
Practice Address - Country:US
Practice Address - Phone:321-354-9207
Practice Address - Fax:321-586-2226
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4997237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist