Provider Demographics
NPI:1306012299
Name:KURZMAN, CHARITY (MED, EDS)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:KURZMAN
Suffix:
Gender:F
Credentials:MED, EDS
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:
Other - Last Name:STAPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1860 N PINE ISLAND RD STE 101
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5234
Mailing Address - Country:US
Mailing Address - Phone:954-557-4235
Mailing Address - Fax:954-678-0696
Practice Address - Street 1:1860 N PINE ISLAND RD STE 101
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5234
Practice Address - Country:US
Practice Address - Phone:954-557-4235
Practice Address - Fax:954-678-0696
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8755101YM0800X
FLMT 2184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist