Provider Demographics
NPI:1083742332
Name:ROBERT A KURTIS MD PA
Entity Type:Organization
Organization Name:ROBERT A KURTIS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-461-2401
Mailing Address - Street 1:611 DRUID RD E
Mailing Address - Street 2:SUITE 511
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3959
Mailing Address - Country:US
Mailing Address - Phone:727-461-2401
Mailing Address - Fax:
Practice Address - Street 1:611 DRUID RD E
Practice Address - Street 2:SUITE 511
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3959
Practice Address - Country:US
Practice Address - Phone:727-461-2401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0026717207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56321Medicare UPIN
FLAE649Medicare PIN