Provider Demographics
NPI:1760429989
Name:KUNIS, CHRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:KUNIS
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 1:2102 SW 20TH PL BLDG 100
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0856
Mailing Address - Country:US
Mailing Address - Phone:352-867-5800
Mailing Address - Fax:352-867-5809
Practice Address - Street 1:2102 SW 20TH PL BLDG 100
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0856
Practice Address - Country:US
Practice Address - Phone:352-867-5800
Practice Address - Fax:352-867-5809
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLME0085972207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57653OtherBCBS NON PAR NUMBER
FLC32507Medicare UPIN
FLE8581YMedicare ID - Type UnspecifiedPROVIDER NUMBER