Provider Demographics
NPI:1871752964
Name:NANCY HUNDT, M.D., P.A.
Entity type:Organization
Organization Name:NANCY HUNDT, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:941-505-5500
Mailing Address - Street 1:25086 OLYMPIA AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3933
Mailing Address - Country:US
Mailing Address - Phone:941-505-5500
Mailing Address - Fax:941-505-5501
Practice Address - Street 1:25086 OLYMPIA AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3933
Practice Address - Country:US
Practice Address - Phone:941-505-5500
Practice Address - Fax:941-505-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071843207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42836OtherBCBS
FL42836AMedicare PIN
FL42836OtherBCBS