Provider Demographics
NPI:1033450200
Name:WILLIAM J. KUZBYT, PSY.D., PA
Entity Type:Organization
Organization Name:WILLIAM J. KUZBYT, PSY.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUZBYT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:239-898-7099
Mailing Address - Street 1:4061 BONITA BEACH RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4074
Mailing Address - Country:US
Mailing Address - Phone:239-898-7099
Mailing Address - Fax:239-300-2759
Practice Address - Street 1:4061 BONITA BEACH RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4074
Practice Address - Country:US
Practice Address - Phone:239-898-7099
Practice Address - Fax:239-300-2759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6646103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty