Healthcare Provider Details

I. General information

NPI: 1548311657
Provider Name (Legal Business Name): MICHELE Q. KUZNITZ CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21018 COUNTRY CREEK DR
BOCA RATON FL
33428-1140
US

IV. Provider business mailing address

21018 COUNTRY CREEK DR
BOCA RATON FL
33428-1140
US

V. Phone/Fax

Practice location:
  • Phone: 561-482-7037
  • Fax:
Mailing address:
  • Phone: 561-482-7037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN 2865592
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: