Provider Demographics
NPI:1245784149
Name:KUSSEL & ASSOCIATES INC
Entity Type:Organization
Organization Name:KUSSEL & ASSOCIATES INC
Other - Org Name:TAMPA BAY PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-797-5007
Mailing Address - Street 1:2378 SUNSET POINT RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1430
Mailing Address - Country:US
Mailing Address - Phone:727-797-5007
Mailing Address - Fax:
Practice Address - Street 1:1302 W SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2531
Practice Address - Country:US
Practice Address - Phone:813-250-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KUSSEL & ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2632213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty