Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | ME0067778 | FL |
NPI | 1063405108 |
---|---|
Provider Name | Jorge A Kusnir |
First Address | Winter Park, FL 32789-4870 |
Second Address | Orlando, FL 32804-4603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 23/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
207369 | AVMED (01) | FL |
26635 | BCBS (01) | FL |
377188100 | (05) | FL |
390003710 | RAILROAD MEDICARE (01) | FL |
F47499 | (02) | FL |