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General NPI Number Information
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NPI Number | 1346782398
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Entity Type | Individual
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Provider Name | TYSON H KUCH R.N., PHD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 434 W KENNEDY BLVD
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City | ORLANDO
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State | FL
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Zip | 32810-6237
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Country | US
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Telephone | 407-875-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 ADANSON STREET C/O HUMAN RESOURCES
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City | ORLANDO
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State | FL
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Zip | 32804
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Country | US
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Telephone | 407-875-3770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN9314850
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License Number State | FL
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