Provider Demographics
NPI:1427329986
Name:KURZ, FREDERICK JOHN (RPH)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:JOHN
Last Name:KURZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25201 WESLEY CHAPEL BLVD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-7201
Mailing Address - Country:US
Mailing Address - Phone:813-373-7799
Mailing Address - Fax:813-949-4816
Practice Address - Street 1:25201 WESLEY CHAPEL BLVD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-7201
Practice Address - Country:US
Practice Address - Phone:813-373-7799
Practice Address - Fax:813-949-4816
Is Sole Proprietor?:No
Enumeration Date:2012-01-14
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist