Provider Demographics
NPI:1972596948
Name:AMUNDARAY, JOSE A (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:AMUNDARAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:410 CELEBRATION PL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5433
Mailing Address - Country:US
Mailing Address - Phone:321-939-0222
Mailing Address - Fax:407-303-4271
Practice Address - Street 1:2954 MALLORY CIR STE 101
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-1822
Practice Address - Country:US
Practice Address - Phone:321-939-0222
Practice Address - Fax:407-288-1996
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2022-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME78202207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259655500Medicaid
FL259655500Medicaid