Individual
DR. PICHAPONG TUNSUPON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9430 TURKEY LAKE RD STE 110, ORLANDO, FL 32819-8015
(321) 841-7856
(321) 843-6432
Mailing address
9430 TURKEY LAKE RD STE 110, ORLANDO, FL 32819-8015
(321) 841-7856
(321) 843-6432
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.018973
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME129427
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME129427
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021282900
—
FL
Enumeration date
07/22/2011
Last updated
07/02/2021
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