Healthcare Provider Details

I. General information

NPI: 1730277948
Provider Name (Legal Business Name): JOSEPH KURSTIN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 SW 37TH AVE
MIAMI FL
33145-1754
US

IV. Provider business mailing address

1661 SW 37TH AVE
MIAMI FL
33145-1754
US

V. Phone/Fax

Practice location:
  • Phone: 305-461-2400
  • Fax: 305-461-2902
Mailing address:
  • Phone: 305-461-2400
  • Fax: 305-461-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0012092
License Number StateFL

VIII. Authorized Official

Name: DR. M. JOSEPH KURSTIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-461-2400