Organization
DR EBENEZER A KUMA MD PA
Active
Other names
Children's-Family Medi-Centre
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EBENEZER KUMA MD (PRESIDENT)
(941) 625-4919
Entity
Organization
Contact information
Practice address
3406 TAMIAMI TRL UNIT 2, PORT CHARLOTTE, FL 33952-8152
(941) 625-4919
(941) 625-5516
Mailing address
3406 TAMIAMI TRL UNIT 2, PORT CHARLOTTE, FL 33952-8152
(941) 625-4919
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
56904
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062636800
—
FL
01
—
1225038144
INDIVIDUAL NPI
FL
Enumeration date
12/04/2008
Last updated
12/04/2008
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