Provider Demographics
NPI:1477010650
Name:KUZMA, CANDACE (DO)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:KUZMA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RODEL CV STE 201
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4859
Mailing Address - Country:US
Mailing Address - Phone:407-878-4729
Mailing Address - Fax:
Practice Address - Street 1:725 RODEL CV STE 201
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4859
Practice Address - Country:US
Practice Address - Phone:407-878-4729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19798207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine