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General NPI Number Information
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NPI Number | 1417154808
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Entity Type | Organization
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Legal Business Name | KIRTMED, INC.
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 734 NW 101ST TER
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City | PLANTATION
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State | FL
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Zip | 33324-1061
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Country | US
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Telephone | 954-673-5058
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Fax | 954-424-9064
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Provider Business Mailing Address
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Address Line | 734 NW 101ST TER
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City | PLANTATION
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State | FL
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Zip | 33324-1061
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Country | US
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Telephone | 954-673-5058
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Fax | 954-424-9064
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAY KIRTMAN
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Credential |
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Telephone | 954-673-5058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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