Healthcare Provider Details

I. General information

NPI: 1528045747
Provider Name (Legal Business Name): BRIAN DANIEL KURLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13782 PLANTATION RD UNIT103
FORT MYERS FL
33912-4462
US

IV. Provider business mailing address

13782 PLANTATION RD SUITE 103
FORT MYERS FL
33912-4462
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-8575
  • Fax: 239-936-7664
Mailing address:
  • Phone: 239-936-8575
  • Fax: 239-936-7664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME66590
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: