Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | ME91372 | FL |
NPI | 1043209950 |
---|---|
Provider Name | Dr. Gopal R. Kunta |
First Address | Clermont, FL 34711-6699 |
Second Address | Clermont, FL 34711-6699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 02/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
271823500 | (05) | FL |
G99828 | (02) | FL |