| Entity Name: | JOANNE KUNDL, OD,PA-II |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 May 2002 (23 years ago) |
| Document Number: | P02000056960 |
| FEI/EIN Number | 364497007 |
| Address: | 10521 N KENDALL DR STE E-103, MIAMI, FL, 33176 |
| Mail Address: | 7030 SW 82 AVE, MIAMI, FL, 33143 |
| ZIP code: | 33176 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770574683 | 2005-10-31 | 2010-05-13 | 10521 N KENDALL DR, STE E103, MIAMI, FL, 331761554, US | 10521 N KENDALL DR, SUITE E 103, MIAMI, FL, 331761554, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-279-2212 |
| Fax | 3052793746 |
Authorized person
| Name | DR. JOANNE KUNDL |
| Role | OPTOMETRIST |
| Phone | 3052792212 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | 00001665 |
| State | MA |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 078231900 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 19664A |
| State | FL |
| Issuer | AVMED |
| Number | 277057 |
| State | FL |
| Issuer | MEDICAID |
| Number | 620744800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KUNDL JOANNE | Agent | 7030 SW 82 AVE, MIAMI, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| KUNDL JOANNE | President | 7030 SW 82 AVE, MIAMI, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| KUNDL JOANNE | Director | 7030 SW 82 AVE, MIAMI, FL, 33143 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
