Healthcare Provider Details

I. General information

NPI: 1184016560
Provider Name (Legal Business Name): KATHERINE KURETSKI KHOURY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE KURETSKI KHOURY APRN

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 KYOTO GARDENS DR STE A
PALM BEACH GARDENS FL
33410-2899
US

IV. Provider business mailing address

PO BOX 850001, DEPT 8340
ORLANDO FL
32885-0001
US

V. Phone/Fax

Practice location:
  • Phone: 561-776-8891
  • Fax: 866-436-2183
Mailing address:
  • Phone: 813-536-7277
  • Fax: 855-830-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9363854
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: