Individual
JONATHAN B RUNION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 9101816
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292925200
—
FL
01
—
Y05FT
BCBS
FL
Enumeration date
10/29/2007
Last updated
09/21/2010
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