Provider Demographics
NPI:1205820784
Name:KURTZMAN, BENITA P (MD)
Entity type:Individual
Prefix:
First Name:BENITA
Middle Name:P
Last Name:KURTZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 W PALMETTO PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3892
Mailing Address - Country:US
Mailing Address - Phone:561-395-7616
Mailing Address - Fax:561-395-1399
Practice Address - Street 1:120 W PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3892
Practice Address - Country:US
Practice Address - Phone:561-395-7616
Practice Address - Fax:561-395-1399
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME49063207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D57275Medicare UPIN
FL180004989Medicare Oscar/Certification
FL0548040001Medicare NSC
FL61549Medicare ID - Type Unspecified