Provider Demographics
NPI:1073509758
Name:KUTZA, GERALD H (RPH)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:H
Last Name:KUTZA
Suffix:
Gender:M
Credentials:RPH
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Other - Credentials:
Mailing Address - Street 1:1601 SW ARCHER RD
Mailing Address - Street 2:PHARMACY SERVICE (119) VA MEDICAL CENTER
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1135
Mailing Address - Country:US
Mailing Address - Phone:352-377-8224
Mailing Address - Fax:352-379-4139
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:PHARMACY SERVICE (119) VA MEDICAL CENTER
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:352-377-8224
Practice Address - Fax:352-379-4139
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPS 14015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist