Provider Demographics
NPI:1417154808
Name:KIRTMED, INC.
Entity Type:Organization
Organization Name:KIRTMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-673-5058
Mailing Address - Street 1:734 NW 101ST TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1061
Mailing Address - Country:US
Mailing Address - Phone:954-673-5058
Mailing Address - Fax:954-424-9064
Practice Address - Street 1:734 NW 101ST TER
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1061
Practice Address - Country:US
Practice Address - Phone:954-673-5058
Practice Address - Fax:954-424-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherUNITED HEALTHCARE