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Individual

DR. PAUL EDGAR RUNGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13411 BLYTHEFIELD TER, LAKEWOOD RANCH, FL 34202-2456
(941) 894-4400
Mailing address
13411 BLYTHEFIELD TER, LAKEWOOD RANCH, FL 34202-2456
(941) 894-4400

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
19486
TN
207W00000X
Ophthalmology Physician
ME58780
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
A39159
CA
208000000X
Pediatrics Physician
A39159
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0401145
GHI
FL
01
0805726
UNITED HEALTHCARE
FL
01
0927003
AETNA HMO
FL
01
31874
BCBS/FL
FL
01
3488212-001
CIGNA PAL
FL
05
379992100
FL
01
4197868
AETNA PPO, MC, EC
FL
01
ME0058780
FL LICENSE
FL
Enumeration date
06/30/2005
Last updated
12/27/2023
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