Provider Demographics
NPI:1467970038
Name:KORUNDA MEDICAL, LLC
Entity Type:Organization
Organization Name:KORUNDA MEDICAL, LLC
Other - Org Name:KORUNDA PAIN MANAGEMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZDENKO
Authorized Official - Middle Name:
Authorized Official - Last Name:KORUNDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-591-2803
Mailing Address - Street 1:PO BOX 110820
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0114
Mailing Address - Country:US
Mailing Address - Phone:239-591-2803
Mailing Address - Fax:239-594-5637
Practice Address - Street 1:8340 COLLIER BLVD STE 307
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3626
Practice Address - Country:US
Practice Address - Phone:239-591-2803
Practice Address - Fax:239-594-5637
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KORUNDA MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-05
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS111782081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty