# DAVID M KANUCK D P M PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174727812
- **Authorized official:** DAVID M KANUCK DPM (OWNER)
- **Authorized official phone:** (239) 481-7000

## Contact information

- **Practice address:** 3191 HARBOR BLVD, STE B, PORT CHARLOTTE, FL 33952-6755
- **Practice address phone:** (239) 481-7000
- **Practice address fax:** (239) 481-8150
- **Mailing address:** 8851 BOARDROOM CIR, FORT MYERS, FL 33919-4888
- **Mailing address phone:** (239) 481-7000
- **Mailing address fax:** (239) 481-8150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO3295 | FL | Yes |

## Other

- **Enumeration date:** 06/14/2007
- **Last updated:** 03/03/2011