Provider Demographics
NPI:1427667401
Name:BUNAG, CYRA MAE MALGAPO (MMSC, PA-C)
Entity type:Individual
Prefix:
First Name:CYRA MAE
Middle Name:MALGAPO
Last Name:BUNAG
Suffix:
Gender:F
Credentials:MMSC, PA-C
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Mailing Address - Street 1:PO BOX 746654
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6654
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-393-7603
Practice Address - Street 1:1301 PALM AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8432
Practice Address - Country:US
Practice Address - Phone:904-202-7300
Practice Address - Fax:904-202-7433
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2022-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9113589363A00000X, 363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant