Provider Demographics
NPI:1689839912
Name:KEITH A KURLAND MD PA
Entity Type:Organization
Organization Name:KEITH A KURLAND MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KURLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-755-6100
Mailing Address - Street 1:10139 NW 31ST ST
Mailing Address - Street 2:STE 202
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3908
Mailing Address - Country:US
Mailing Address - Phone:954-755-6100
Mailing Address - Fax:954-345-3754
Practice Address - Street 1:10139 NW 31ST ST
Practice Address - Street 2:STE 202
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3908
Practice Address - Country:US
Practice Address - Phone:954-755-6100
Practice Address - Fax:954-345-3754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME004427305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0897420001Medicare NSC
FL79865Medicare UPIN