Provider Demographics
NPI:1033192307
Name:KURLAND, KEITH ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALAN
Last Name:KURLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9138
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33075-9138
Mailing Address - Country:US
Mailing Address - Phone:954-755-6100
Mailing Address - Fax:954-345-3754
Practice Address - Street 1:10139 NW 31ST ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3908
Practice Address - Country:US
Practice Address - Phone:954-755-6100
Practice Address - Fax:954-345-3754
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44278207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D58958Medicare UPIN
FL79865Medicare ID - Type Unspecified