Provider Demographics
NPI:1386892404
Name:KURUVILLA, STEVE JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:JOSE
Last Name:KURUVILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2884 YELLOW BARN LN
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-6879
Mailing Address - Country:US
Mailing Address - Phone:631-525-8078
Mailing Address - Fax:
Practice Address - Street 1:2884 YELLOW BARN LN
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-6879
Practice Address - Country:US
Practice Address - Phone:631-525-8078
Practice Address - Fax:631-444-6031
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL1697462084P0800X
NY329844-012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program