Provider Demographics
NPI:1417532706
Name:KUNZMAN, JOANNE DAWN
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:DAWN
Last Name:KUNZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5604
Mailing Address - Country:US
Mailing Address - Phone:727-431-0278
Mailing Address - Fax:727-431-0155
Practice Address - Street 1:2102 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5604
Practice Address - Country:US
Practice Address - Phone:727-431-0278
Practice Address - Fax:727-431-0155
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT80519183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician