MEDICARE: ANDREA KURTZ N.P

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist	NC420	FL

General Provider Information

NPI Number	:	1982953493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA KURTZ N.P

Provider Business Mailing Address
First Line	:	2240 NE 123RD ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2904
Country	:	US
Telephone Number	:	305-895-5533
Fax Number	:	305-895-8952

Provider Business Practice Location Address
First Line	:	2240 NE 123RD ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2904
Country	:	US
Telephone Number	:	305-895-5533
Fax Number	:	305-895-8952

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2012
Last Update Date	:	08/30/2012

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