Provider Demographics
NPI:1487686853
Name:KURITZKY, LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:KURITZKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LOUIS
Other - Middle Name:
Other - Last Name:KURITZKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-392-4541
Mailing Address - Fax:352-392-4549
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-392-2891
Practice Address - Fax:352-392-4549
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067674800Medicaid
01350VMedicare PIN
FL067674800Medicaid