Provider Demographics
NPI:1184816209
Name:KUCZYNSKI, ALAN HERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:HERMAN
Last Name:KUCZYNSKI
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 1:5983 NW 91ST AVE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3742
Mailing Address - Country:US
Mailing Address - Phone:954-227-0680
Mailing Address - Fax:
Practice Address - Street 1:5983 NW 91ST AVE
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-3742
Practice Address - Country:US
Practice Address - Phone:954-227-0680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00035476174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist