Provider Demographics
NPI:1528344306
Name:HUMBERTO A. JUNCO CST/CFA, LLC
Entity type:Organization
Organization Name:HUMBERTO A. JUNCO CST/CFA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:A
Authorized Official - Last Name:JUNCO
Authorized Official - Suffix:
Authorized Official - Credentials:CST
Authorized Official - Phone:305-502-9838
Mailing Address - Street 1:686 NW 127 COURT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1897
Mailing Address - Country:US
Mailing Address - Phone:305-502-9838
Mailing Address - Fax:954-436-9146
Practice Address - Street 1:686 NW 127TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-1897
Practice Address - Country:US
Practice Address - Phone:305-502-9838
Practice Address - Fax:954-436-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00F425246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1487884144OtherINDIVIDUAL NPI