Healthcare Provider Details

I. General information

NPI: 1306396536
Provider Name (Legal Business Name): KIRSTEN LUFT AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE INSTITUTE BLDG. 5TH FLOOR, ROOM 515A
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1611 NW 12TH AVE INSTITUTE BLDG. 5TH FLOOR, ROOM 515A
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-7725
  • Fax: 305-355-2432
Mailing address:
  • Phone: 305-585-7725
  • Fax: 305-355-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number9229292
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: