Provider Demographics
NPI:1487635652
Name:LUNSETH, PAUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:LUNSETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5115 N ARMENIA AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1405
Mailing Address - Country:US
Mailing Address - Phone:813-636-2000
Mailing Address - Fax:813-321-1878
Practice Address - Street 1:4211 VANDYKE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-8004
Practice Address - Country:US
Practice Address - Phone:813-264-6490
Practice Address - Fax:813-321-1878
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2016-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME21821207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055535500Medicaid
FLD53721Medicare UPIN
FL055535500Medicaid