Healthcare Provider Details

I. General information

NPI: 1356429617
Provider Name (Legal Business Name): GARY L CURSON PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 12/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9528 HARDING AVE
SURFSIDE FL
33154-2502
US

IV. Provider business mailing address

9528 HARDING AVE
SURFSIDE FL
33154-2502
US

V. Phone/Fax

Practice location:
  • Phone: 305-865-2281
  • Fax: 305-868-6824
Mailing address:
  • Phone: 305-865-2281
  • Fax: 305-868-6824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO0001529
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: