Healthcare Provider Details

I. General information

NPI: 1891809448
Provider Name (Legal Business Name): JEFFERY JOHN KUHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PL STE 100
CELEBRATION FL
34747-5432
US

IV. Provider business mailing address

410 CELEBRATION PL STE 100
CELEBRATION FL
34747-5432
US

V. Phone/Fax

Practice location:
  • Phone: 321-939-3000
  • Fax: 321-939-3001
Mailing address:
  • Phone: 321-939-3000
  • Fax: 321-939-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35.120170
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number0101241725
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number35.120170
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME168413
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: