Healthcare Provider Details

I. General information

NPI: 1215790514
Provider Name (Legal Business Name): INEKE LIAUWAPAU KURLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 N US HIGHWAY 1
SEBASTIAN FL
32958-7524
US

IV. Provider business mailing address

8701 N US HIGHWAY 1
SEBASTIAN FL
32958-7524
US

V. Phone/Fax

Practice location:
  • Phone: 772-228-8480
  • Fax: 772-228-8481
Mailing address:
  • Phone: 772-228-8480
  • Fax: 772-228-8481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11029419
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: