Basic Information
| Provider Information | |||||||||
| NPI: | 1063730323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KURITZKY | ||||||||
| FirstName: | BENJAMIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8240 NORTHCREEK DR STE 1100 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452360707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138531300 | ||||||||
| FaxNumber: | 5134514118 | ||||||||
| Practice Location | |||||||||
| Address1: | 7651 MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | HUDSON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278689208 | ||||||||
| FaxNumber: | 7278686420 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2010 | ||||||||
| LastUpdateDate: | 08/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LP01847 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | ME127162 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RX0202X | ME127162 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0003X | 35.131077 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 017345100 | 05 | FL | MEDICAID | H573280 | 01 | OH | MEDICARE | OTHER | 0231815 | 05 | OH | MEDICAID |