Provider Demographics
NPI:1528029535
Name:KURTIN, JENNIFER M (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:KURTIN
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 1:1109 NE JENSEN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4707
Mailing Address - Country:US
Mailing Address - Phone:772-335-3500
Mailing Address - Fax:772-335-1361
Practice Address - Street 1:1109 NE JENSEN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4707
Practice Address - Country:US
Practice Address - Phone:772-335-3500
Practice Address - Fax:772-335-1361
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8311207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261379400Medicaid
FL261379400Medicaid
FLE51124Medicare ID - Type Unspecified