Healthcare Provider Details

I. General information

NPI: 1043318348
Provider Name (Legal Business Name): JEFF R KURZON LHAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6044 S ORANGE AVE
ORLANDO FL
32809-4283
US

IV. Provider business mailing address

6044 S ORANGE AVE
ORLANDO FL
32809-4283
US

V. Phone/Fax

Practice location:
  • Phone: 407-855-9799
  • Fax:
Mailing address:
  • Phone: 407-855-9799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS2572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: