Provider Demographics
NPI:1346643772
Name:BERTSCHINGER, KURT (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:BERTSCHINGER
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 1:1250 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2221
Mailing Address - Country:US
Mailing Address - Phone:941-363-0878
Mailing Address - Fax:
Practice Address - Street 1:282 APOLLO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2261
Practice Address - Country:US
Practice Address - Phone:941-363-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME971822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA75430Medicare UPIN