Provider Demographics
NPI:1770610206
Name:DAVID KURTZ MD PA
Entity type:Organization
Organization Name:DAVID KURTZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-659-7702
Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE 9400
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3422
Mailing Address - Country:US
Mailing Address - Phone:561-659-7702
Mailing Address - Fax:561-659-7821
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 9400
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3422
Practice Address - Country:US
Practice Address - Phone:561-659-7702
Practice Address - Fax:561-659-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58226174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064476500Medicaid
FLE61866Medicare UPIN
FL064476500Medicaid