Provider Demographics
NPI:1871518787
Name:BUNYI, PATRICK P (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:P
Last Name:BUNYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:7451 103RD ST STE 8
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-9300
Practice Address - Country:US
Practice Address - Phone:904-683-4968
Practice Address - Fax:904-902-1202
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME68800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS737OtherMEDICARE
FL113009700Medicaid
FL27690OtherBCBS