Provider Demographics
NPI:1215911821
Name:HUNEK, JEFFREY R (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:R
Last Name:HUNEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 COMMERCIAL CT STE E
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1651
Mailing Address - Country:US
Mailing Address - Phone:941-486-1404
Mailing Address - Fax:
Practice Address - Street 1:395 COMMERCIAL CT STE E
Practice Address - Street 2:STE A
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1651
Practice Address - Country:US
Practice Address - Phone:941-486-1404
Practice Address - Fax:941-613-2401
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93357207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00238253OtherRAILROAD MEDICARE
FL2570886OtherUHC
FL7887740OtherAETNA
FL28672OtherBC/BS FLORIDA
FL7130217OtherCIGNA
FL7887740OtherAETNA
FL28672ZMedicare PIN