Healthcare Provider Details

I. General information

NPI: 1104871391
Provider Name (Legal Business Name): DONALD ROBERTSON KUHL APA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6213 AVIATION AVE
JACKSONVILLE FL
32221-8113
US

IV. Provider business mailing address

203 COKESBURY CT
GREEN COVE SPRINGS FL
32043-9519
US

V. Phone/Fax

Practice location:
  • Phone: 904-594-6864
  • Fax: 904-594-6836
Mailing address:
  • Phone: 808-753-4237
  • Fax: 904-594-6836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5095
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: