MEDICARE: RICHARD A KUSHNICK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	ME46481	FL
2	207L00000X	Anesthesiology Physician	102068-875	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144285974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A KUSHNICK MD

Provider Business Mailing Address
First Line	:	4631 NW 31ST AVE
Second Line	:	C/O ANESCO ANESTHESIA ASSOC
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3433
Country	:	US
Telephone Number	:	954-485-5666
Fax Number	:	954-484-1651

Provider Business Practice Location Address
First Line	:	5757 N DIXIE HWY
Second Line	:	C/O NORTH RIDGE MEDICAL CENTER
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-4135
Country	:	US
Telephone Number	:	954-776-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	11/05/2024

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Directions to “ RICHARD A KUSHNICK MD” Practice Location

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