Healthcare Provider Details

I. General information

NPI: 1285609107
Provider Name (Legal Business Name): MADELYNNE M KUGLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9836 US HIGHWAY 441
LEESBURG FL
34788-3918
US

IV. Provider business mailing address

16140 US HIGHWAY 441
EUSTIS FL
32726-6508
US

V. Phone/Fax

Practice location:
  • Phone: 352-360-6548
  • Fax: 352-589-6496
Mailing address:
  • Phone: 352-589-6424
  • Fax: 352-589-6496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP2242552
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: