Individual
DR. JONATHAN NEAL RUNYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1005 JOE DIMAGGIO DR, HOLLYWOOD, FL 33021-5487
(954) 265-6301
(954) 985-1434
Mailing address
1117 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009-4488
(954) 454-5131
(954) 261-6908
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME144468
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118231500
—
FL
Enumeration date
04/13/2017
Last updated
08/02/2023
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