Provider Demographics
NPI:1467714980
Name:JUNCADELLA, ANNA C (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:C
Last Name:JUNCADELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 CREEKSIDE BLVD E UNIT 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0595
Mailing Address - Country:US
Mailing Address - Phone:239-624-8070
Mailing Address - Fax:239-624-8071
Practice Address - Street 1:1285 CREEKSIDE BLVD E UNIT 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0595
Practice Address - Country:US
Practice Address - Phone:239-624-8070
Practice Address - Fax:239-624-8071
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-251777207R00000X
FLME136594207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100441900Medicaid
FLJL427ZOtherMEDICARE
FL2FZCWOtherBCBS