Provider Demographics
NPI:1740726959
Name:KUSSEL & ASSOCIATES
Entity type:Organization
Organization Name:KUSSEL & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-797-5007
Mailing Address - Street 1:1302 W SWANN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2531
Mailing Address - Country:US
Mailing Address - Phone:813-250-3668
Mailing Address - Fax:813-250-1515
Practice Address - Street 1:1302 W SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2531
Practice Address - Country:US
Practice Address - Phone:813-250-3668
Practice Address - Fax:813-250-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009413200Medicaid
FLAM116Medicare PIN