Healthcare Provider Details

I. General information

NPI: 1750126280
Provider Name (Legal Business Name): SYDNEY KUES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PLANTATION ISLAND DR S
ST AUGUSTINE FL
32080-3106
US

IV. Provider business mailing address

352 JASMINE RD
ST AUGUSTINE FL
32086-6436
US

V. Phone/Fax

Practice location:
  • Phone: 904-342-3225
  • Fax:
Mailing address:
  • Phone: 440-376-6164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: