Provider Demographics
NPI:1902198609
Name:BUNCE, JUDY
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:BUNCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9858 CLINT MOORE RD
Mailing Address - Street 2:SUITE C111-274
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1034
Mailing Address - Country:US
Mailing Address - Phone:561-482-1144
Mailing Address - Fax:561-482-1145
Practice Address - Street 1:7035 BERACASA WAY
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3405
Practice Address - Country:US
Practice Address - Phone:561-361-4888
Practice Address - Fax:561-361-4999
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1482171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist