Provider Demographics
NPI:1922035088
Name:KUON, ALBINO Y (MD)
Entity Type:Individual
Prefix:
First Name:ALBINO
Middle Name:Y
Last Name:KUON
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 1:4360 NORTH US1
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927
Mailing Address - Country:US
Mailing Address - Phone:321-632-3130
Mailing Address - Fax:321-632-2947
Practice Address - Street 1:4360 NORTH US1
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927
Practice Address - Country:US
Practice Address - Phone:321-632-3130
Practice Address - Fax:321-632-2947
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME461712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05574OtherBLUE SHIELD
FL05574Medicare ID - Type Unspecified
FLD61251Medicare UPIN