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Individual

DR. KEITH ROBERTS RUNYAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3305 W MARITANA DR, ST PETE BEACH, FL 33706
(813) 502-0529
Mailing address
3305 W MARITANA DR, ST PETE BEACH, FL 33706
(813) 502-0529

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME62416
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
262962300
FL
01
ME62416
STATE LICENSE NUMBER
FL
Enumeration date
12/13/2005
Last updated
07/09/2018
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