Provider Demographics
NPI:1508137092
Name:KURZAWA, SCOTT (RPH)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:KURZAWA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-5366
Mailing Address - Country:US
Mailing Address - Phone:352-238-1334
Mailing Address - Fax:
Practice Address - Street 1:140 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-5366
Practice Address - Country:US
Practice Address - Phone:352-238-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0027659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist