Michele Mills Kunkle, LPN,CSFA,CSA

Individual provider Active NPI Surgical Assistant · Osprey, FL

NPI 1407095425 · NPPES record last updated Dec 3, 2018

Key facts

NPI
1407095425
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Assistant 246ZC0007X
License
PN 1325501 (FL)
Practice address
116 Candyce Dr
Osprey, FL 34229-9629
Phone
(941) 539-5443
Fax
(941) 445-5218
NPI assigned
Feb 14, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN 1325501FLMDSurgical Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X
Surgical Assistant 246ZC0007X PN 1325501 FL Yes

Addresses

Primary practice location

116 Candyce Dr
Osprey, FL 34229-9629

Mailing address

116 Candyce Dr
Osprey, FL 34229-9629
Phone (941) 539-5443

Other providers in Osprey, FL

All providers in Osprey, FL · Surgical Assistant in Florida

Sources for this page

Verify at the official NPI Registry.