Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO0001946 | FL |
Y | 222Z00000X | Podiatrist | PO0001946 | FL |
NPI | 1003852450 |
---|---|
Provider Name | Dr. Scott Paul Kurecki |
First Address | North Port, FL 34287-1934 |
Second Address | North Port, FL 34287-1934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 05/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
029759300 | (05) | FL |
480007561 | RAILROAD MEDICARE (01) | FL |
65088 | BC/BS OF FLORIDA (01) | FL |
BK1421659 | DEA NUMBER (01) | FL |
N7786 | MEDICARE EDI SENDER NUMBR (01) | FL |
T14295 | (02) | FL |