Provider Demographics
NPI:1659661932
Name:KURITZKY-HAVENS, ARIELLE ELENA (DO)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:ELENA
Last Name:KURITZKY-HAVENS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:
Other - Last Name:SLOAN-KURITZKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4510 NW 17TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3479
Mailing Address - Country:US
Mailing Address - Phone:407-342-0351
Mailing Address - Fax:
Practice Address - Street 1:4510 NW 17TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3479
Practice Address - Country:US
Practice Address - Phone:407-342-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA70949207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program