Provider Demographics
NPI:1306804679
Name:KRUDO, LOUIS (AP)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:KRUDO
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8140 PICTON WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655
Mailing Address - Country:US
Mailing Address - Phone:727-375-9700
Mailing Address - Fax:727-375-9720
Practice Address - Street 1:8140 PICTON WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655
Practice Address - Country:US
Practice Address - Phone:727-375-9700
Practice Address - Fax:727-375-9720
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1278171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP1278OtherSTATE LICENSE NUMBER