Provider Demographics
NPI:1508338039
Name:KRUSZKA, LI H (DNP, APRN, NP-C)
Entity Type:Individual
Prefix:DR
First Name:LI
Middle Name:H
Last Name:KRUSZKA
Suffix:
Gender:F
Credentials:DNP, APRN, NP-C
Other - Prefix:
Other - First Name:LI
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 NW 70TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2911
Mailing Address - Country:US
Mailing Address - Phone:954-900-8981
Mailing Address - Fax:954-516-0637
Practice Address - Street 1:150 NW 70TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2911
Practice Address - Country:US
Practice Address - Phone:954-900-8981
Practice Address - Fax:954-516-0637
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2022-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110379200Medicaid