Healthcare Provider Details

I. General information

NPI: 1063730323
Provider Name (Legal Business Name): BENJAMIN KURITZKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7651 MEDICAL DR
HUDSON FL
34667
US

IV. Provider business mailing address

8240 NORTHCREEK DR STE 1100
CINCINNATI OH
45236-0707
US

V. Phone/Fax

Practice location:
  • Phone: 727-868-9208
  • Fax: 727-868-6420
Mailing address:
  • Phone: 513-853-1300
  • Fax: 513-451-4118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLP01847
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME127162
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME127162
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35.131077
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: