Provider Demographics
NPI:1518258086
Name:KUNZ, VINCENT PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:PATRICK
Last Name:KUNZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 MONTE CRISTO BLVD
Mailing Address - Street 2:
Mailing Address - City:TIERRA VERDE
Mailing Address - State:FL
Mailing Address - Zip Code:33715-2034
Mailing Address - Country:US
Mailing Address - Phone:727-743-1303
Mailing Address - Fax:
Practice Address - Street 1:690 MONTE CRISTO BLVD
Practice Address - Street 2:
Practice Address - City:TIERRA VERDE
Practice Address - State:FL
Practice Address - Zip Code:33715-2034
Practice Address - Country:US
Practice Address - Phone:727-743-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77205208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery