Healthcare Provider Details

I. General information

NPI: 1154768737
Provider Name (Legal Business Name): SUZANNE ALICE KUHANECK RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 06/01/2020
Certification Date: 06/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11701 BELCHER RD S STE 126
LARGO FL
33773-5117
US

IV. Provider business mailing address

1652 WHITEWOOD DR
CLEARWATER FL
33756-2428
US

V. Phone/Fax

Practice location:
  • Phone: 727-523-2515
  • Fax:
Mailing address:
  • Phone: 727-460-9443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP039061L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS29839
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: