Fred Kusumoto
Clinical Cardiac Electrophysiologist
4500 San Pablo Rd S
Jacksonville
, Florida 32224-1865
Fred Kusumoto
Clinical Cardiac Electrophysiologist
4500 San Pablo Rd S
Jacksonville
, Florida 32224-1865
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About
Features
Specialties
- Clinical Cardiac Electrophysiologist
Languages spoken
- English
Location
First Address
- Fred Kusumoto
- 4500 San Pablo Rd S
- Jacksonville, FL
- Zip : 32224-1865
- Phone :
Second Address
- Fred Kusumoto
- 4500 San Pablo Rd S
- Jacksonville, FL
- Zip : 32224-1865
- Phone : (904) 953-2000
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME91015 | FL |
National Provider Identifier
| NPI | 1265429427 |
|---|---|
| Provider Name | Fred Kusumoto |
| First Address | Jacksonville, FL 32224-1865 |
| Second Address | Jacksonville, FL 32224-1865 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/10/2005 |
| Last Update Date | 31/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E74529 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.