Healthcare Provider Details

I. General information

NPI: 1497970750
Provider Name (Legal Business Name): NATALIE M KUWIK L.M.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2374 YALTA TER
NORTH PORT FL
34286-6733
US

IV. Provider business mailing address

2374 YALTA TER
NORTH PORT FL
34286-6733
US

V. Phone/Fax

Practice location:
  • Phone: 941-429-2382
  • Fax:
Mailing address:
  • Phone: 941-429-2382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA31074
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: