Provider Demographics
NPI:1992068902
Name:JOSE ACUNA MD, P.A.
Entity type:Organization
Organization Name:JOSE ACUNA MD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ACUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-937-6067
Mailing Address - Street 1:1500 LAKELAND HILLS BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3257
Mailing Address - Country:US
Mailing Address - Phone:863-333-0200
Mailing Address - Fax:863-937-7398
Practice Address - Street 1:1500 LAKELAND HILLS BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3257
Practice Address - Country:US
Practice Address - Phone:863-333-0200
Practice Address - Fax:863-937-7398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty