Organization
PROFESSIONAL PARK PEDIATRICS P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER G. BUNNELL III M.D. (PRESIDENT)
(850) 402-5454
Entity
Organization
Contact information
Practice address
1881 PROFESSIONAL PARK CIR, SUITE 80, TALLAHASSEE, FL 32308-4541
(850) 402-5454
(850) 402-5451
Mailing address
1881 PROFESSIONAL PARK CIR, SUITE 80, TALLAHASSEE, FL 32308-4541
(850) 402-5454
(850) 402-5451
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME37597
FL
208000000X
Pediatrics Physician
ME75773
FL
208000000X
Pediatrics Physician
Primary
ME82183
FL
208000000X
Pediatrics Physician
ME91797
FL
Other
Enumeration date
10/18/2005
Last updated
09/09/2009
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