Individual
JOANNA R. RUNKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 N MILLS AVE, ORLANDO, FL 32803-5722
(407) 581-9180
(407) 926-9173
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-4195
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME100734
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003774 00
—
FL
01
—
68430
BCBS
FL
01
—
P00677586
RAILROAD MEDICARE
—
Enumeration date
05/31/2007
Last updated
12/08/2015
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